Effect of perinatal factors on cord blood thyroid stimulating hormone levels

Authors

  • Vikram A. Pawar Department of Paediatrics, SMBT Institute of Health Science and Research Centre, Dhamangaon, Igatpuri, Nasik, Maharashtra, India
  • Swati Jain Department of Paediatrics, SMBT Institute of Health Science and Research Centre, Dhamangaon, Igatpuri, Nasik, Maharashtra, India
  • Vaibhav Pustake Department of Paediatrics, SMBT Institute of Health Science and Research Centre, Dhamangaon, Igatpuri, Nasik, Maharashtra, India
  • Poonam Pawar Department of Paediatrics, SMBT Institute of Health Science and Research Centre, Dhamangaon, Igatpuri, Nasik, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20230720

Keywords:

Congenital hypothyroidism, Cord blood thyroid stimulating hormone, Day 3 thyroid stimulating hormone

Abstract

Background: Screening for congenital hypothyroidism (CH) is a routine practice in most developed countries of the world. This can be done by measuring cord blood thyroid stimulating hormone (CBTSH). Apart from foetal thyroid status and iodine nutrition status of the population, many perinatal factors may also affect CBTSH. The influence of these perinatal factors may affect the sensitivity of CBTSH as a screening tool for CH. The present study was carried out to study the influence of various perinatal factors on CBTSH level.

Methods: It was a cross sectional study conducted in tertiary care centre in North Maharashtra. 793 new-borns were included in study. Effects of perinatal factors like maternal age, parity, gender of the baby, birth weight, mode of delivery, gestational age, birth asphyxia on CBTSH was analysed with appropriate scientific method.

Results: The mean TSH level in the study group was 7.56±3.9 mIU/l. Among the associated factors vaginal delivery, low gestational age, low birth weight and birth asphyxia were significantly associated with elevated CBTSH values. Hence, any rise in cord blood TSH should be seen in the light of these factors.

Conclusions: Among all the associated factors, primi-parity, vaginal delivery, low gestational age, low birth weight and birth asphyxia were significantly associated with elevated CBTSH values. However, no association was observed between CBTSH values and gender of the baby and maternal age.

References

Eng L, Lam L. Thyroid Function During the Fetal and Neonatal Periods. Neoreviews. 2020;21(1):30-6.

American Academy of Pediatrics AAP Section on Endocrinology and Committee on Genetics, and American Thyroid Association Committee on Public Health: Newborn screening for congenital hypothyroidism: recommended guidelines. Pediatrics. 1993;91(6):1203-9.

Rosman NP. Neurological and muscular aspects of thyroid dysfunction in childhood. Pediatr Clin North Am. 1976;23(3):575-94.

Smith DW, Blizzard RM, Wilkins L. The mental prognosis in hypothyroidism of infancy and childhood; a review of 128 cases. Pediatrics. 1957;19(6):1011-22.

Vulsma T, Gons MH, Vijlder JJ. Maternal-fetal transfer of thyroxine in congenital hypothyroidism due to a total organification defect or thyroid agenesis. N Engl J Med. 1989;321(1):13-6.

Delange F, Fisher DA. The thyroid gland. Clinical Pediatric Endocrinology. In: Brook CGD, eds, 3rd ed. Oxford: Blackwell Science; 1995: 406-419.

Delange F. Screening for congenital hypothyroidism used as an indicator of the degree of iodine deficiency and of its control. Thyroid. 1998;8(12):1185-92.

Pandav CS, Kochupillai N. Organisation and implementation of neonatal hypothyroid screening programme in India--a primary health care approach. Indian J Pediatr. 1985;52(416):223-9.

Wassenaer AG, Kok JH, Dekker FW, Vijlder JJ. Thyroid function in very preterm infants: influences of gestational age and disease. Pediatr Res. 1997;42(5):604-9.

Wang Y, Liu R, Guo J. Study on effect of delivery way on thyrotropin levels in pregnant women and their newborns. Zhonghua Fu Chan Ke Za Zhi. 2001;36(5):282-4.

Lee SS, Lao TT. Cord blood thyrotrophin and foetal presentation at delivery in singleton pregnancies. Gynecol Obstet Invest. 1997;43(2):94-7.

Chan LY, Leung TN, Lau TK. Influences of perinatal factors on cord blood thyroid-stimulating hormone level. Acta Obstet Gynecol Scand. 2001;80(11):1014-8.

Durga D, Rudrappa S, Kumar R, Manjunath SN. Prenatal Factors Influencing the Interpretation of Cord Blood Thyroid Stimulating Hormone Levels. Int J Sci Stud. 2015;2(12):104-9.

Fuse Y, Wakae E, Nemoto Y, Uga N, Tanaka M, Maeda M, et al. Influence of perinatal factors and sampling methods on TSH and thyroid hormone levels in cord blood. Endocrinol Jpn. 1991;38(3):297-302.

Lakshminarayana SG, Sadanandan NP, Mehaboob AK, Gopaliah LR. Effect of maternal and neonatal factors on cord blood thyroid stimulating hormone. Indian J Endocrinol Metab. 2016 May;20(3):317-23.

Rashmi, Seth A, Sekhri T, Agarwal A. Effect of perinatal factors on cord blood thyroid stimulating hormone levels. J Pediatr Endocrinol Metab. 2007;20(1):59-64.

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.

Garg P. To study umbilical cord blood TSH values in newborn in BHMRC over a period of 1 year. Int J Pediatr Res. 2016; 3(2): 105-9.

Kumar V. Maternal and perinatal factors affecting cord blood thyroid stimulating hormone level. JEMDS. 2018;7(19):2415-19.

Franklin RC, Carpenter LM, O'Grady CM. Neonatal thyroid function: influence of perinatal factors. Arch Dis Child. 1985;60(2):141-4.

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Published

2023-03-27

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Original Research Articles