ABSTRACT
Background: Congenital hypothyroidism (CH) is one of the common preventable cause of intellectual disability. Most cases of CH result from thyroid dysgenesis. CH is often asymptomatic in early infancy, and any delay in treatment can affect the child in terms of delayed cognitive milestones. NSCH (newborn screening for congenital hypothyroidism) has been universally accepted and it is one of the most cost effective screening programs in the field of preventive medicine and public health.Methods: A cross sectional study was conducted in Sri Venkata Sai Medical College and Hospital from 28th August to 28th February 2019 (1.5 years), this study was done on 73 newborns (70 deliveries, three mothers gave birth to twins). All data was collected prospectively. Mothers with known thyroid disease or on thyroid medication were excluded from the study. Under sterile aseptic conditions blood sample is collected from the umbilical cord soon after delivery.Results: In the present study Cord blood TSH level of >20 mIU/L was present in 10% (7) of neonates. When the blood TSH levels were repeated (on day 3) among those with high cord blood TSH levels (>20), the blood TSH levels was also high (>20) in 6 (85.7%) neonates and low (<20) in 1 (14.2%). In Neonates with cord blood TSH >20, 6 neonates also had Low T4 (T4<7) levels (85.7%) and 1 neonate (14.2%) had T4 >7. In the present study 6 neonates (85.7%) had Congenital Hypothyroidism. The present study finds that Cord blood TSH as a diagnostic tool has Sensitivity of 100% and specificity of 98.5% in diagnosing congenital hypothyroidism.Conclusions: The current study concludes that Cord blood TSH is a sensitive and specific marker to predict the presence of congenital hypothyroidism in neonates.
ABSTRACT
Congenital Hypothyroidism (CH) is one of the most common disorders related to mental impairment and growth retardation in newborns. The main objective of screening is to detect and treat them early so as to prevent or minimize the neuropsychological damage which can be irreversible if the treatment is delayed beyond the first few weeks of life. In our institution, we do concomitant T4 and TSH after 48 hours of birth for screening. This study is aimed at assessing the usefulness of cord blood thyroid stimulating hormone (CBTSH) screening compared to TSH on 3rd postnatal day. METHODSA retrospective study was done in 272 term neonates at birth to analyse the cord blood TSH levels and TSH levels were tested for on 3rd postnatal day. The values were statistically analysed using Fisher’s exact test.RESULTS272 babies were enrolled in the study. 17 (6.25%) babies had cord blood TSH above 20 mIU/ml and 11 (4.04%) babies had TSH values more than 10 mIU/ml in the 3rd day sample. The mean value of CBTSH was 9.68 microU/ml (SD +/-8.47) and that of 3rd day TSH was 3.76 microU/ml (SD +/- 3.17). 4 out of the 11 babies with elevated TSH levels on 3rd day was found to have congenital hypothyroidism on further follow up.CONCLUSIONSThis study reveals a high proportion of congenital hypothyroidism when compared to national and international references, thus highlighting the need for universal screening. According to our study, cord blood TSH cannot substitute the 3rd day TSH for diagnosing congenital hypothyroidism