A Systematic Review on the Risk Factors of Congenital Hypothyroidism

Hashemipour, Mahin; Samei, Payam; Kelishadi, Roya; Hovsepian, Silva; Zavareh, Neda Hani Tabaei

doi:10.32598/jpr.7.4.199

Cited by 13 publications

(11 citation statements)

References 45 publications

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“…These factors include familial history of the disorder, advanced maternal age, and birth in high-risk geographical areas. 13,14 We did not document any risk factors in our case aside from the maternal age which was > 35 years.…”

Section: Discussioncontrasting

confidence: 54%

Delayed Diagnosis of Congenital Hypothyroidism in a 6-month-old Male Infant in Tamale, Ghana.

2021

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Congenital hypothyroidism is a common inborn endocrine disorder. Asymptomatic presentation in majority of cases mean that its diagnosis may be missed especially in settings where newborn screening is absent. We present a case of delayed diagnosis of congenital hypothyroidism and emphasize on need for high level of suspicion to aid prompt diagnosis and treatment. Our case is a 3 year, 4 months old male, who was first seen at 5 months of age on account of poor growth. He passed meconium after day four of life, developed jaundice in first week of life, and slept a lot in neonatal period. He had coarse faces, protruding tongue, widened anterior fontanelle and herniation of umbilicus. He was started on oral levothyroxine 50 microgram daily. In resources limited settings where universal newborn screening is absent, healthcare workers should have a high level of suspicion in picking up the early signs of the condition.

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Section: Discussioncontrasting

confidence: 54%

Delayed Diagnosis of Congenital Hypothyroidism in a 6-month-old Male Infant in Tamale, Ghana.

2021

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“…The prevalence of CH for the rest of the world is 1:2118 in Alabama (a USA state) [ 25 ], 1:1684 in Oregon (a USA state) [ 26 ], 1:469 in Turkey [ 27 ], and 1:834 in Saudi Arabia [ 28 ]. The obtained results in Iran are far higher than the incidence rates in other parts of the world, which can be due to the low cut-offs for CH suspicion in the screening tests, the Iranian gene pool, ethnicity, autoimmune factors, parental consanguinity, and iodine deficiency [ 14 ]. Due to cultural differences, parental consanguinity is more accepted in Iran.…”

Section: Discussionmentioning

confidence: 99%

“…The transient form is due to exposure of the placental to antithyroid medications or antithyroid receptor antibodies, excess or deficiency in iodine level, preterm neonates with very low birth weight, thyroid iodine organification immaturity, or DUOX2 mutations. However, permanent CH is mostly caused by thyroid agenesis or dyshormonogenesis [ 14 , 15 ]. In Iran, transient CH rate amongst the confirmed cases varies from 56.46 % in Mazandaran to 36 % in Hamadan [ 16 – 19 ], which is much higher than the 10–15 % reported by the other countries [ 20 – 22 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and predictive factors of transient and permanent congenital hypothyroidism in Fars province, Iran

et al. 2021

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Introduction There is no data on the number as well as the prevalence of congenital hypothyroidism (CH) in the Fars province. Hence, we designed this study to analyze the latest data and the possible predictive factors on transient and permanent CH in this province. Method This cross sectional study is based on the Fars province screening data from 2013 to 2016. A total of 294,214 newborns were screened with 938 confirmed cases of CH, which were included in this study. After recall and completion of the missing data, follow-up data for 642 CH cases with thyroid stimulating hormone (TSH) concentrations and levothyroxine doses for ten outpatient visits and final transient vs. permanent CH diagnosis were included. Results The incidence rate was 1:313.66, and out of the 642 CH cases, 66.04 % had permanent CH, while 33.96 % had transient CH. TSH level trend during the outpatient visits were not statistically different between the two groups (P = 0.312). A cutoff point of > 2.25 levothyroxine µg/kg (sensitivity: 76.11 %, specificity: 58.52 %) at the third year and a TSH concentration of > 43.35 mIU/L at the venous sampling (initial TSH) (sensitivity: 31.66 %, specificity: 90.32 %) were the predictive factors for permanent CH. Conclusion Fars province has one of the highest incidence rate of CH in Iran. Levothyroxine dose at the 3rd year and the 1st venous TSH sample are the predictive factors for permanent CH in the Iranian population; however, TSH concentrations during follow ups are unreliable predictors.

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“…In our study, 4.82% of neonates had CB-TSH values more than 20 micro IU/ml, similar to Laxmi Narayana (5.42) [22] which reflects a higher recall rate when compared to Manglik (1.83%) [3] and Wu (2.27%) [37] but even higher values were observed in other studies by Nasheda (5.8%) [39] , Poornima Kumar (8.1%) [29] and Gupta (11.5%) [6] , etc. Several authors have postulated that CB-TSH levels can be influenced by factors such as perinatal asphyxia, difficult deliveries_ Rashmi [9] and Laxmi Narayana [22] , perinatal stress events, birth weight, gestational age,_ Tim et al [27] , male sex_ Chan Ly [25] and Mahin Hashemipour [28] and following instrumental delivery, or by cesarean section as the mode of delivery_ Chan Ly [25] , but the mechanism is poorly understood. The postnatal surge in TSH levels, common to all the neonates, is considered to be mediated through the alphaadrenergic stimulation following the stress of parturition, which is likely to be more in neonates born by normal vaginal delivery than in those born by elective cesarean section for any indication.…”

Section: Discussionmentioning

confidence: 99%

Unfolding the perinatal factors that affect cord blood thyroid stimulating hormone levels- an experience from a rural centre in southern India

K¹,

P²,

B³

et al. 2020

Int. J. Paediatrics Geriatrics

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To evaluate the incidence of congenital hypothyroidism using cord blood thyroid stimulating hormone (CB-TSH) levels and examining the influence of maternal and perinatal factors on these levels in our cohort of babies. Design: A cross-sectional study. Setting: Tertiary care teaching hospital, China Kakani, A.P. Methods: CB-TSH levels were measured in 2012 live-born neonates using electro chemiluminescence immunoassay. The effect of various maternal and perinatal factors on CB-TSH levels was analyzed statistically by multivariate analysis. Results: The mean CB-TSH was 8.86 micro IU/ml (ranged between 0.23 to 100micro IU/ml). The incidence of high CB-TSH (>20microIU/ml) was 4.82%. CB-TSH levels were significantly raised in neonates delivered in 1 st and 2 nd birth order, assisted vaginal deliveries, need for emergency section, and who were born with low APGAR scores (p<0.01 and Cron-bach's alfa 0.932). Maternal hypothyroidism or maternal hypertension, weight appropriateness for gestation, birth weight and gestational age had no significance. Conclusion: Upon multivariate analysis, the need for resuscitation, mode of delivery, and birth order were found to be significant factors affecting CB-TSH levels. Hence, these factors must be considered cautiously while interpreting CB-TSH values.

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A Systematic Review on the Risk Factors of Congenital Hypothyroidism

Cited by 13 publications

References 45 publications

Delayed Diagnosis of Congenital Hypothyroidism in a 6-month-old Male Infant in Tamale, Ghana.

Delayed Diagnosis of Congenital Hypothyroidism in a 6-month-old Male Infant in Tamale, Ghana.

Prevalence and predictive factors of transient and permanent congenital hypothyroidism in Fars province, Iran

Unfolding the perinatal factors that affect cord blood thyroid stimulating hormone levels- an experience from a rural centre in southern India

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