Objectives: The fundamental prerequisite of a screening program is the accessible epidemiological data regarding disease burden and awareness regarding the disorder. This is the foremost study in this state to estimate the burden of congenital hypothyroidism (CH) and glucose-6-phosphate dehydrogenase (G6PD) enzyme deficiency in infants born or attending a tertiary care hospital, pursuing skill development for the technical staffs, and creating awareness for parents. Study Design: A cross-sectional study for 21 months was conducted in the Department of Biochemistry in collaboration with the Department of Pediatrics and Department of Obstetrics and Gynecology. Methods: The screening was conducted on 1282 babies, 48 hours subsequent to birth and up to 8 weeks of age. The dried blood spot specimens collected were analyzed for thyroid stimulating hormone (TSH) level and G6PD enzyme activity by fluoroimmunoassay method. Prevalence was calculated by percentage. Results: The proficiency of the program for all live birth babies delivered in the institute was 94.6%. In consequence to improper sampling, 4.1% samples could not be analyzed. The screening tests reported elevated TSH levels in 1.6% of total population and G6PD enzyme deficiency in 2.6% of all babies enrolled. Confirmatory tests revealed that 4 (3.1/1000) babies were declared positive for CH and 8 (6.2/1000) were announced to be G6PD deficient. Conclusion: The new prevalence observed is one of the highest prevalence of CH published in India that urges mandatory and immediate need for development of newborn screening program in the state, and improvisation and upgradation of regional diagnostic center with facilities for primary- and secondary-level testing.

Objectives: LBW is the strong determinant of neonatal morbidity and mortality with a global prevalence of nearly 15%. India's prevalence, though not yet established, ranges from 16-30% and influenced by maternal nutritional status, antenatal care and associated maternal morbidity. Hence, the study was aimed to determine the influencing parameters for occurrence of LBW. Study Design: A retrospective observational study conducted for all live newborns delivered in a tertiary care centre during the study period of twenty four months. Methods: Data from institutional medical record section was recorded on predesigned questionnaire from a total of 1216 newborns. Results: The percentage of LBW was found to be 27.55% (335/1216) with a proportion of LBW to NBW babies was approximately 1:3. The occurrence of LBW was significantly higher in babies of anemic mothers (59.39%, P < 0.0001), young mothers (30.39%, P < 0.01), mothers with parity ≥ 3 (35.71%, P < 0.05), those with <3 ANC check-up (56.88%, P < 0.0001) and those with premature delivery (71.57%, P < 0.0001). Maternal anemia (OR 4.7, 95%CI 3.4-6.7, P < 0.001); ANC with <3 visits (OR 2.2, 95%CI 1.4-3.4, P < 0.01) and prematurity (OR 7.6, 95%CI 5.1-11.2, P < 0.0001) were considered as independent risk factor for LBW. Significant association of neonatal complications was found with LBW babies (OR 1.6, 95%CI 1.1-2.5, P < 0.05). Conclusions: Inadequate antenatal care, maternal anemia and other maternal illness causing premature delivery are considered critical determinants for LBW and thus associated with high neonatal mortality and morbidity. Continued focus for improving the overall maternal health status would lead to lowering burden of LBW.

Introduction: Newborn Screening (NBS) is considered the need of the hour for quality health in neonates. It is also important to understand that the rising trend of prevalence of inherited metabolic disorders and the various maternal factors that might influence genetic changes in the foetus in- utero affecting the neonatal outcome. Aim: The primary objective of the study was to determine frequency of Congenital Hypothyroidism (CH) and Glucose- 6-Phosphate Dehydrogenase (G6PD) deficiency in a most approachable tertiary care hospital. The secondary objectives were to find out impact of maternal factors on the frequency of the disease and the impact of the disorder on the neonate’s health. Materials and Methods: The cross-sectional study was conducted on 1282 neonates of 48 hours upto eight weeks of age. The Dried Blood Spot (DBS) specimens collected were analysed for Thyroid Stimulating Hormone (TSH) level and G6PD enzyme activity. Details of neonatal characteristics and antenatal history were documented. Prevalence of CH and G6PD deficiency was calculated and maternal and neonatal variables were analysed for association using Statistical Package for the Social Sciences (SPSS) version 20. Results: The prevalence of CH and G6PD were respectively 3.3/1000 and 6.6/1000 making the overall prevalence of metabolic disorders as 9.8/1000. A 27.3% had Low Birth Weight (LBW) and 62% had low Ponderal Index (PI). The odds for raised TSH was 6.62 times in sick neonates. The probability for high TSH in LBW babies was more by 94% and in female neonates by 18%. The neonates with higher TSH values depicted significant association with maternal age (p=0.016), gestational age (p=0.019) and maternal anaemia (p<0.001). Babies born by caesarean section showed twice the chances for screening positive for TSH. Conclusion: The high prevalence estimated in this study and association with maternal factors urges new queries and recommends an obligatory need for NBS program in this region.

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