Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases

Abstract

a b s t r a c tCONTEXT: Screening programs not only offer the opportunity to trace and treat almost all cases of congenital hypothyroidism but also mean large savings to the health system. However, carefully planned strategies are necessary to extend their benefits and reduce costs. OBJECTIVE:To determine the possible influence of maternal diseases that affect maternal-fetal placenta dynamics on primary thyroid stimulating hormone (TSH) screening for congenital hypothyroidism. DESIGN:Prospective non-randomized clinical trial with at least 3 months of follow-up. SETTING:A public university referral center [CAISM/Hospital das Clínicas, Faculty of Medicine, University of Campinas, Campinas, SP].PARTICIPANTS: 415 neonates divided into 5 groups: eighty-three infants born from cardiac mothers; 98 from mothers that had toxemia; 54 of the mothers had diabetes mellitus; 40 were HIV positive and 140 had no diseases. INTERVENTION:All newborns had cord blood samples collected on filter paper at birth. MAIN MEASUREMENTS:TSH was measured from dried blood spots using a homemade immunofluorescence assay (sensitivity in dried blood spots = 0.1 mU/L). RESULTS:There was no significant difference in the mean TSH levels among the 5 groups. Moreover, TSH levels were around 5 mU/L in 48% of the newborns, indicating that our region is severely deficient in iodine. CONCLUSIONS:Our results indicate that primary TSH screening programs using cord blood are not affected by maternal diseases. We suggest that, besides its technical advantages over heel punctures with T 4 primary approaches, neonatal screening using primary cord blood TSH may also be used as a monitoring tool for evaluation and control of iodine deficiency disorders (IDD).

Congenital hypothyroidism in neonates

“…Authors also found that CH was more common in newborn, whose hypothyroid mothers did not take the anti-thyroid drug during pregnancy. Similar observations were made by Ward et al [11] in USA and Abbas et al [8] and Karam et al [10] in Pakistan.…”

“…These results are in accordance with the study by Adeniran et al [9] in which authors found the majority of newborns appropriate for the age. Similarly, our results are also supported in Pakistan by Abbas et al [8] However, Ward et al [11] found low birth weight newborns in their study. The difference may be due to the fact that we did not include low birth weight newborns in the present study.…”

“…These results are in supported by international [11] and local data. [810] However, Adeniran et al [9] reported female preponderance.…”

Neonatal thyroid screening: Relationship between cord blood thyroid stimulating hormone levels and thyroid stimulating hormone in heel prick sample on 4 th to 7 th day-of-life

“…[ 1 ] These include the following: (1) The TSH-CB screening program has been found to be not affected by non-thyroidal mothers’ diseases, notably toxemia of pregnancy, diabetes mellitus, and positive HIV status. [ 2 ] (2) The TSH-CB screening program can be also used as a monitoring tool for the evaluation and control of iodine deficiency disorders in a given population. [ 2 3 4 ]…”

“…[ 2 ] (2) The TSH-CB screening program can be also used as a monitoring tool for the evaluation and control of iodine deficiency disorders in a given population. [ 2 3 4 ]…”