SCREENING FOR CONGENITAL HYPOTHYROIDISM WITH UMBILCAL CORD BLOOD TSH LEVEL ‘AN EXPERIENCE FROM A TERTIARY CARE CENTER'

Author:

Modi Rohan1,Mod Harsh2,Phalak Aabha3,Parikh Rutvik4,Kavad Vilas5,Prajapati Baldev S6

Affiliation:

1. 3 Year Resident.

2. Assistant Professor.

3. 2 Year Resident

4. Assistant Professor

5. 3 Year Resident

6. Professor & HOD

Abstract

BACKGROUND:- Congenital hypothyroidism (CH) is the most common preventable cause of mental retardation. Screening for congenital hypothyroidism can be helpful in preventing mental retardation among general population. Umbilical cord blood TSH (CBTSH) estimation has been universally accepted and is one of the most cost effective screening programs in the field of preventive medicine and public health. AIMS AND OBJECTIVES:- This study was aimed to find the effectiveness of cord blood TSH as a screening tool for congenital hypothyroidism. MATERIALS AND METHODS:- This hospital based cross sectional study was conducted at GCS Medical College Hospital & Research Centre, Ahmedabad, over a period of one year in 1687 neonates. All newborns delivered at the institute were subjected to cord blood TSH level estimation and a repeat Serum TSH estimation was done at or after 72 hours of life. Diagnosis of congenital hypothyroidism is confirmed postnatally by standard Serum TSH value cut offs as per age. Data collected and statistically analysed. RESULTS:- Out of 1687 neonates born during the study period, 1548 formed the study group. 805 (52%) were males and 743(48%) were females. The birth weight of babies ranged from 850 gms to 4300 gms. The value of CBTSH varied from 1.3mIU/L to 101.4mIU/L with mean CBTSH of 7.21mIU/L. 28(1.8%) babies had CBTSH levels >20mIU/L. Out of which four were later diagnosed to have congenital hypothyroidism. All four had CBTSH levels >20mIU/L. All other neonates with CBTSH levels less than 20mIU/L were found to have normal screening later postnatally. CONCLUSION:- The current study concludes that cord blood TSH is a sensitive marker to screen for congenital hypothyroidism in neonates. A cut off value of cord blood TSH >20mIU/ml can be used for screening purpose.

Publisher

World Wide Journals

Reference16 articles.

1. Desai MP,Colaco MP, Ajgaonkar AR, Mahadik CV, Vas FE, Rege W, et al. Neonatal screening for congenital hypothyroidism in a developing country: problems and strategies. Indian J Pediatrics. 1987; 54:571-81.

2. Desai MP, Upadhaya P, Colaco MP, Mehere M, Naik SP, Vaz FE, et al. Neonatal screening for congenital hypothyroidism using filter paper thyroxine technique. Indian J Med Res. 1994; 10036-42.

3. Newborn screening for congenital hypothyroidism: recommended guidelines: American Academy of Pediatrics Section on Endocrinology and Committee on Genetics and American Thyroid Association Committee on Public Health. Pediatrics. 1993; 91:1203-09

4. Nanayakkaral D, Wijekoon A, Jiffry N, Mudiyanse R, Nilam J, Perera K, et al. Screening for congenital hypothyroidism in government hospitals in Sri Lanka. Proceedings of the Peradeniya University Research Sessions, Sri Lanka. 2007; 12: 133-34.

5. Ordooei M, Mottaghipisheh H, Fallah R, Rabiee A. Cognitive outcomes of congenital hypothyroid and healthy children: a comparative study. Iranian journal of child Neurology. 2014; 8(4):28.

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