ABSTRACT
This study was aimed to evaluate the situation of congenital hypothyroidism [CH] in Guilan using the screening program and determine the correlation of CH with birth weight, gestational age and seasonality. During 2006 to 2010, in Guilan province, neonatal screening for CH by measurement of serum TSH level was performed in 3-5 days after birth. All neonates with TSH level >/= 5mu/l were referred to endocrinologists and serum TSH, T3 and T4 were measured. Based on public health data and profiles, total number of newborns, gestational age, route of delivery, birth season and birth weight in all screened neonates was reviewed and for ones with CH, their TSH measurements was also recorded. During 5 years, 119701 neonates were screened and CH was confirmed in 10.8% [221] of the referral cases [prevalence=1:542]. No significant statistical difference was seen between gender and birth season among patients with CH and the rest of the population. Interestingly, low birth weight [LBW] [31% vs. 4.9%, P<0.01], postdate delivery [1.4% vs. 0.2%, P<0.01] and macrosomia were more prevalent in CH versus normal population [Odds ratio for post-date delivery was 6.9 and for LBW was 3.2]. Rate of normal vaginal delivery [NVD] was significantly higher in neonates with CH compared to normal population [39.2% vs. 29.2%, P=0.01]. LBW, postdate delivery and macrosomia are risk factors for CH. No association between sex, birth season or caesarian section delivery was seen
ABSTRACT
Comparison of the prevalence of Iodine Deficiency Disorder [IDD] in neonates and school children using two different WHO indicators. From 2006 to 2010, 119701 newborns were screened by measurement of serum TSH level by heel prick. Neonates who had blood TSH >/= 5 mIU/l were recalled for more evaluation. In the same period of time, urine iodine was measured in 1200 school-aged children. The severity of IDD was classified using WHO, UNICEF, ICCIDD criteria. Between 2006 and 2010 a total of 138832 neonates were screened in Guilan province and the total recall rate [neonates with TSH level >/= 5 mIU/l] was 1.8%. The incidence rate of Congenital Hypothyroidism [CH] was 1/625. The median urine iodine level in school-aged children was 200-299 micro g/l. Considering the WHO, UNICEF, ICCIDD criteria, Guilan province would be classified as a none-IDD endemic area. However, health care systems should pay attention to the iodine excess and the risk of iodine induced hyperthyroidism in this population