Using Thyroid Stimulating Hormone (TSH) Levels in Cord Blood to Assess the Iodine Status of Neonates

@#Neonatal Thyroid Stimulating Hormone (TSH) level in blood is one of the indicators recommended for assessing iodine deficiency control programs in a population. This study evaluates the TSH level in cord blood as a way of assessing the iodine status of neonates in the National Capital District, PNG. Assay of TSH in 150 cord sera was by enzyme immunoassay (EIA 96 Microwell plates) using the sensitive EIA kit provided by LiNEAR Chemicals, S.L. The median TSH level in the sera for all the neonates was 2.17mIU/L, the interquartile range (IQR) was 1.53 – 3.48mIU/L. The TSH level in only 2 (1.3%) cord serum samples was greater than 10.0mIU/L. The lower limit (2.5th) and upper limit (99.0th) of the TSH percentile cut-off levels in all the cord sera were 0.76mIU/L and 11.16mIU/L. The median TSH level in the cord sera of the male neonates was 1.98mIU/L and the IQR was 1.55 – 3.38mIU/L. For the female neonates the median TSH level was 2.22mIU/L and the IQR was 1.52 – 3.81mIU/L. The data indicates normal iodine and thyroid status and zero prevalence of congenital hypothyroidism among the neonates in NCD.

Antepartum prediction of respiratory distress syndrome: a comparison of the shake test, the tap test and the turbidity test

The shake test, the tap test and the turbidity test were evaluated to determine their accuracy in predicting lung function maturity, ie their ability to predict respiratory distress syndrome (RDS). The turbidity test was the most efficient with a sensitivity of 60%, a specificity of 97%, a positive predictive value of 82% and a negative predictive value of 92%. The shake test had a sensitivity of 40%, a specificity of 95%, a positive predictive value of 63% and a negative predictive value of 88%. The tap test at 2 minutes had a sensitivity of 57%, a specificity of 78%, a positive predictive value of 35% and a negative predictive value of 89%. It was fortuitous that the simplest and cheapest test was found to be the most efficient test of the three. We recommend that the turbidity test or at least one of these tests should be used to determine the maturity of lung function when non-urgent elective deliveries are contemplated, to help reduce the incidence of RDS in this group of patients.

A case-control study of early neonatal deaths at the Port Moresby General Hospital to determine associated risk factors

From June 1998 to December 1999, mothers of 150 babies who died in the early neonatal period and 150 controls whose babies did not die were studied. In multiple logistic regression analysis the following variables were positively associated with early neonatal deaths: lack of antenatal attendance, thick meconium staining of the liquor, male sex, very low birthweight and delivery at gestational age less than 34 weeks. Maternal betelnut chewing was negatively associated with neonatal deaths. When babies with birthweight below 1000 g were excluded, the following variables were associated with early neonatal deaths: unmarried status, thick meconium staining of the liquor and gestational age below 34 weeks. The negative association with betelnut chewing persisted. The main causes of early neonatal deaths were respiratory distress syndrome, septicaemia, birth asphyxia, meconium aspiration syndrome and congenital abnormalities. Avoidable factors in these deaths were associated with the patient (53%), the labour ward (28%), the antenatal clinic (9%), the postnatal ward (8%) and the special care nursery (2%).