Prevalence of congenital hypothyroidism in preterm neonates: a NICU-based study
DOI:
https://doi.org/10.18203/2349-3291.ijcp20252599Keywords:
Preterm neonates, Congenital hypothyroidism, Thyroid function, TSH, FT4Abstract
Introduction: Congenital hypothyroidism (CH) is a common endocrine disorder in neonates. Early diagnosis of CH plays a key role in preventing neurodevelopmental impairment in future. Preterm neonates are at higher risk due to their immature hypothalamic-pituitary-thyroid axis. This study aimed to assess the prevalence of congenital hypothyroidism in preterm neonates admitted to the Neonatal Intensive Care Unit (NICU).
Methods: This cross-sectional study was conducted in the Department of Neonatology, Combined Military Hospital, Dhaka, Bangladesh, from July 2016 to December 2016. In this study, we included 50 preterm neonates with gestational ages ranging from 28 to 37 weeks admitted to the Department of Neonatology of our study institution.
Result: The mean age of neonates at sample collection was 5.38±2.66 days. The mean gestational age was 34.06±1.81 weeks. Of the 50 neonates, 27 (54%) were male and 23 (46%) were female, with a male-to-female ratio of 1:0.85. Only 4 (8%) neonates had a maternal history of thyroid disorders. The majority of neonates (50%) were between 32–34 weeks of gestation. Serum TSH and FT4 levels were within normal ranges across all gestational age groups. Only one neonate had a borderline elevated TSH level (10.70 mU/l) with a normal FT4 level, indicating no confirmed cases of congenital hypothyroidism.
Conclusion: This study showed that thyroid function was within normal limits in nearly all preterm neonates, with no confirmed cases of congenital hypothyroidism. Given the potential consequences of undiagnosed thyroid dysfunction, routine screening for thyroid disorders in preterm neonates remains essential for early detection and intervention.
Metrics
References
Rastogi MV, LaFranchi SH. Congenital hypothyroidism. Orphanet J Rare Dis. 2010;5:17. DOI: https://doi.org/10.1186/1750-1172-5-17
Korada M, Pearce MS, Ward Platt MPW, Avis E, Turner S, Wastell H, et al. Repeat testing for congenital hypothyroidism in preterm infants is unnecessary with an appropriate thyroid stimulating hormone threshold. Arch Dis Child Fetal Neonatal Ed. 2008;93:286–8. DOI: https://doi.org/10.1136/adc.2007.134999
Grant DB, Smith I. Survey of neonatal screening for primary hypothyroidism in England, Wales, and Northern Ireland 1982–4. BMJ. 1988;296(6633):1355–8. DOI: https://doi.org/10.1136/bmj.296.6633.1355
Dussault JH. The anecdotal history of screening for congenital hypothyroidism. J Clin Endocrinol Metab. 1999;84:4332. DOI: https://doi.org/10.1210/jc.84.12.4332
Fisher DA, Dussault JH, Foley TP. Screening for congenital hypothyroidism: Results of screening one million North American infants. J Pediatr. 1979;94:700. DOI: https://doi.org/10.1016/S0022-3476(79)80133-X
Nanayakkara D, Wijekoon A, Jiffry N, Mudiyanse R, Nilam J, Perera K, et al. Screening for congenital hypothyroidism in government hospitals in Sri Lanka. Proc Peradeniya Univ Res Sess. 2007;12(1):163–4.
Wassenaer AG, Kok JH. Thyroid function and thyroid hormone requirements of very preterm infants. NeoReviews. 2000;1:116–21. DOI: https://doi.org/10.1542/neo.1-6-e116
Chung HR, Shin CH, Yang SW, Choi CW, Kim BI, Kim EK, et al. High incidence of thyroid dysfunction in preterm infants. J Korean Med Sci. 2009;24(4):627–31. DOI: https://doi.org/10.3346/jkms.2009.24.4.627
Bellisario R, Colinas RJ, Pass KA. Simultaneous measurement of thyroxine and thyrotropin from newborn dried blood-spot specimens using a multiplexed fluorescent microsphere immunoassay. Clin Chem. 2000;46:1422–4. DOI: https://doi.org/10.1093/clinchem/46.9.1422
Smith LIZ. Updated AAP guidelines on newborn screening and therapy for congenital hypothyroidism. Am Fam Physician. 2007;76(3):439–44.
Rasul CH, Lucky SN, Miah SR, Moslem F. Congenital hypothyroidism in the Southern Bangladesh. TAJ. 2008;21(1):18–22. DOI: https://doi.org/10.3329/taj.v21i1.3212
Roberts HE, Moore CA, Fernhoff PM, Khoury MJ, Young M, Mann MY, et al. Population study of congenital hypothyroidism and associated birth defects, Atlanta, 1979–1992. Am J Med Genet. 1997;71:29. DOI: https://doi.org/10.1002/(SICI)1096-8628(19970711)71:1<29::AID-AJMG5>3.0.CO;2-L
Al-Maghamsi MS, Al-Hawsawi ZM, Ghulam GN, Okasha AM. Screening for congenital hypothyroidism in North-West region of Saudi Arabia. Saudi Med J. 2002;23(12):1518–21.
Limperopoulos C. Positive screening for autism in ex-preterm infants: prevalence and risk factors. Pediatrics. 2008;121(4):758–65. DOI: https://doi.org/10.1542/peds.2007-2158
Tyson JE. Intensive care for extreme prematurity—moving beyond gestational age. N Engl J Med. 2008;358(16):1672–81. DOI: https://doi.org/10.1056/NEJMoa073059
Hovi P. Glucose regulation in young adults with very low birthweight. N Engl J Med. 2007;356(20):2053–63. DOI: https://doi.org/10.1056/NEJMoa067187
Abdullah AH, Azad K, Nahar N, Bhattacharya P, Banik NG. TSH assay using dried blood samples: a screening method for congenital hypothyroidism. Bangladesh Med Res Counc Bull. 1999;25(2):27–34.
Mengreli C, Kanaka-Gantenbein C, Girginoudis P, Magiakou MA, Christakopoulou I, Giannoulia-Karantana A, et al. Screening for congenital hypothyroidism: the significance of threshold limit in false-negative results. J Clin Endocrinol Metab. 2010;95(9):4283–90. DOI: https://doi.org/10.1210/jc.2010-0057
Freire C, Ramos R, Amaya E, Fernández MF, Santiago-Fernández P, Lopez-Espinosa MJ, et al. 2010. Newborn TSH concentration and its association with cognitive development in healthy boys. Eur J Endocrinol. 2010;163(6):901–9. DOI: https://doi.org/10.1530/EJE-10-0495
Hertzberg VS, Hinton CF, Therrell BL, Shapira SK. Birth prevalence rates of newborn screening disorders in relation to screening practices in the United States. The J Pediat. 2011;159(4):555-60. DOI: https://doi.org/10.1016/j.jpeds.2011.04.011
Kramer MS, Morin I, Yang H, Platt RW, Usher R, McNamara H, Joseph KS, Wen SW. Why are babies getting bigger. Temporal trends in fetal growth and its determinants. J Pediat. 2002;141(4):538-42. DOI: https://doi.org/10.1067/mpd.2002.128029