Umbilical cord blood TSH level: correlation with congenital hypothyroidism

Authors

  • Mahesh Reddy Jillela Department of Pediatrics, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, Bommakal, Telangana, India
  • Padmaja Reddy Keshireddy Department of Paediatrics, Niloufer Hospital, Hyderabad, India
  • Seshagiri Goli Department of Pediatrics, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, Bommakal, Telangana, India
  • Archana Chiluka Department of Pediatrics, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, Bommakal, Telangana, India
  • Ramya Chitgope Department of Pediatrics, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, Bommakal, Telangana, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20212473

Keywords:

Thyroid stimulating hormone, Cord blood TSH, Congenital hypothyroidism, Emergency LSCS, Gestational diabetes mellitus

Abstract

Background: Congenital hypothyroidism is the most common preventable cause of mental retardation. Screening methods include measuring cord blood and venous blood TSH level. The objective of this study was to determine the impact if any of various risk factors affecting these levels.

Methods: It was a cross sectional study done at our hospital and 263 cord blood samples were collected and TSH levels measured. The variables included in the study are parity of mother, GDM, mode of delivery, birth weight, gestational age, sex, weight appropriate for gestation, Apgar score.

Results: In our study 35 among 263 cord blood samples were found to have CB TSH levels above the cut off value of 20 mIU/l and repeat venous sampling done on fifth day of life showed only one sample had high TSH with low free T4 levels and remaining 34 samples showed TSH levels which were significantly down from the earlier peak. The p value, ROC curve, test of significance and criterion cut off levels were made for each of the variables mentioned above. Among the variables studied, mode of delivery (<0.001), gestational age (p=0.001), low Apgar score (p=0.001) had p values which were statistically significant.

Conclusions: Incidence of congenital hypothyroidism in our study is 0.0038%. There was no sexual predilection and the high cord blood TSH levels may be due to perinatal stress factors such as emergency LSCS, low Apgar score and prematurity which had significant positive correlation as evidenced with p values (≤0.001).

Author Biography

Seshagiri Goli, Department of Pediatrics, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, Bommakal, Telangana, India

Pediatrics                                                                                associate professor

References

Gopalakrishnan V, Joshi K, Phadke S, Dabadghao P, Agarwal M, Das V, et al. Newborn screening for congenital hypothyroidism, galactosemia and biotinidase deficiency in Uttar Pradesh, India. Indian Pediatr. 2014;51(9):701-5.

Radwin LS, Michelson JP. End results in treatment of congenital hypothyroidism; follow-up study of physical, mental and behavioral development. Am J Dis Child. 1949;78(6):821-43.

Anand MR, Ramesh P, Nath D. Congenital Hypothyroidism Screening with Umbilical Cord Blood: Retrospective Analysis. Indian Pediatr. 2015;52(5):435-6.

Ogundele MO, Waterson M. When should we be conducting thyroid function tests in newborns and young infants?. Arch Dis Child. 2010;95(2):151-2.

Ford G, Franchi SH. Screening for congenital hypothyroidism: a worldwide view of strategies. Best Pract Res Clin Endocrinol Metab. 2014;28(2):175-87.

Afroze B, Humayun KN, Qadir M. Newborn screening in Pakistan- lessons from a hospital-based congenital hypothyroidism screening programme. Ann Acad Med Singap. 2008;37(12):114-3.

Hashemipour M, Hovsepian S, Kelishadi R, Iranpour R, Hadian R, Haghighi S, et al. Permanent and transient congenital hypothyroidism in Isfahan-Iran. J Med Screen. 2009;16(1):11-6.

Waller DK, Anderson JL, Lorey F, Cunningham GC. Risk factors for congenital hypothyroidism: an investigation of infant's birth weight, ethnicity, and gender in California, 1990-1998. Teratology. 2000;62(1):36-41.

Castanet M, Polak M, Bonaiti PC, Lyonnet S, Czernichow P, Leger J, et al. Nineteen years of national screening for congenital hypothyroidism: familial cases with thyroid dysgenesis suggest the involvement of genetic factors. J Clin Endocrinol Metab. 2001;86(5):2009-14.

Franchi SH. Hypothyroidism. Pediatr Clin North Am. 1979;26(1):33-51.

Julvez J, Alvarez PM, Rebagliato M, Murcia M, Forns J, Garcia ER, Lertxundi N, et al. Thyroxine levels during pregnancy in healthy women and early child neurodevelopment. Epidemiology. 2013;24(1):150-7.

Rama DAR, Naushad SM. Newborn screening in India. Indian J Pediatr. 2004;71(2):157-60.

Jain V, Agarval R, Deorari A, Paul V. Congenital Hpothyroidism. AIIMS-NICU Protocols 2008. 2015;1-18.

Herbstman J, Apelberg BJ, Witter FR, Panny S, Goldman LR. Maternal, infant, and delivery factors associated with neonatal thyroid hormone status. Thyroid. 2008;18(1):67-76.

Kim K, Park SK, Song CH, Lim SC. Perinatal factors affecting thyroid stimulating hormone [TSH] and thyroid hormone levels in cord blood. Korean J Pediatr. 2005;48:143-7.

Gupta A, Srivastava S, Bhatnagar A. Cord blood thyroid stimulating hormone level--interpretation in light of perinatal factors. Indian Pediatr. 2014;51(1):32-6.

Rama Devi AR, Naushad SM. Newborn screening in India. Indian J Pediatr. 2004;71(2):157-60.

Kaur G, Srivastav J, Jain S, Chawla D, Chavan BS, Atwal R, Randhawa G, et al. Preliminary report on neonatal screening for congenital hypothyroidism, congenital adrenal hyperplasia and glucose-6-phosphate dehydrogenase deficiency: a Chandigarh experience. Indian J Pediatr. 2010;77(9):969-73.

Mikelsaar RV, Zordania R, Viikmaa M, Kudrjavtseva G. Neonatal screening for congenital hypothyroidism in Estonia. J Med Screen. 1998;5(1):20-1.

Downloads

Published

2021-06-24

Issue

Section

Original Research Articles