Cord blood spot thyroid stimulating hormone for screening of congenital hypothyroidism
DOI:
https://doi.org/10.18203/2349-3291.ijcp20201640Keywords:
Cord blood, Heel prick, Hypothyroidism, Thyroid stimulating hormoneAbstract
Background: Congenital hypothyroidism is one of the most common causes of mental retardation in pediatric age group. Screening for congenital hypothyroidism is one of most cost effective tools to prevent mental retardation among the general population. Umblical cord TSH estimation remains an easily available option for screening of congenital hypothyroidism. Aims and objectives was to estimate correlation between TSH obtained from cord blood TSH and heel prick TSH at 3rd day of life using blood spot. To estimate the predictability to rule out congenital hypothyroidism using cord blood spot TSH and to determine whether cord blood TSH can be advocated to screen congenital hypothyroidism.
Methods: Prospective study conducted in department of Neonatology, IOG, Egmore after obtaining consent from parents. The study was carried out in two phases. First phase, to establish correlation between cord blood spot TSH and heel prick TSH and to establish median cutoff point of TSH .Second phase, to establish cord blood spot TSH as screening method.
Results: The birth weights ranged between 2.5 to 4.3 kg. TSH values ranged from 2.0-33.3mlU/L. The mean value was 16.45mlU/L. A cutoff value of 20mlU/L was used for recall testing of complete thyroid profile (T3, T4 and TSH). Thirty six infants were recalled for repeating complete thyroid profile.
Conclusions: Congenital hypothyroidism (CH) is the one of the most common preventable causes of mental retardation which can be detected by measuring cord blood TSH .Cord blood TSH can be advocated in national public health program as a routine so that all babies can be tested before discharge thereby minimising interventions for the baby.
Metrics
References
Walfish PG. Evaluation of three thyroid function screening tests for detecting neonatal hypothyroidism. Lancet. 1976;1:1208-10.
Dussault JH, Coulombe P. Laberge C, Letarte J, Guyda H, Khoury K. Preliminary report on a mass screening program for neonatal hypothy-roidism. I Pediatr.1975;86:670-4.
Kempers MJ, Lanting CI, Van Heijst AF, Van Trotsenburg AS, Wiedijk BM, De Vijlder JJ, et al. Neonatal screening for congenital hypothyroidism based on thyroxine, thyro-tropin, and thyroxine-binding globulin mea-surement: potentials and pitfalls. J Clin Endo Metab. 2006 Sep; 91(9):3370-6.
Ward LS, Maciel RM, Magalhães RF, Kunii IS, Kurazawa GK, Matsumura LK, et al. Comparison of two strategies for the early detection of congenital hypothyroidism. Rev Assoc Med Bras. 1998;44:81-6.
Hardy JD, Zayed R, Doss I, Dhatt GS. Cord blood thyroxine and thyroid stimulat-ing hormone screening for congenital hypo-thyroidism: How useful are they? J Pediatric Endocrinal Metab. 2008; 21:245-9.
Mekennon Y, Gizachew WH, Chamiso B, Raue F. Thyroid stimulating hormone values in cord blood in neonates. Ethiop J Health Dev. 2003;17:125-30.
Feleke Y, Enquoselassie F, Deneke F, Abdulkadir J, Hawariat GW, Tilahun M, et al. Neonatal congenital hypothyroidism screening in Addis Ababa, Ethiopia. East Afr Med J. 2000;77:377-81.
Khadilkar V, Khadilkar A, Cowasji H. Neonatal thyroid screening program using filter paper method. Cape News. 2002;6:1.
Manglik AK, Chatterjee N, Ghosh G. Umbilical cord blood TSH levels in term neonates: a screening tool for congenital hypothyroidism. Indian Pediatr. 2005 Oct 1;42(10):1029-32.
Bhatia R, Rajwaniya D. Congenital hypothyroidism screening in term neonates using umbilical cord blood TSH values. Indian J Endocr Metab. 2018;22:277-9.