Cord blood thyroid‐stimulating hormone and free T<sub>4</sub> levels in Turkish neonates: Is iodine deficiency still a continuing problem?

Kışlal, Fatih Mehmet; Çeti̇nkaya, Semra; Dilmen, Uğur; Yaşar, Handan; Teziç, Tahsin

doi:10.1111/j.1442-200x.2010.03169.x

Cited by 12 publications

(18 citation statements)

References 28 publications

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“…The prevalence of transient CH in Turkey is much higher than the expected rate of 5-10% reported for iodine-sufficient populations (14). Numerous studies carried out in newborns (15,16,17) and pregnant women (18,19,20) have already demonstrated that iodine deficiency is a continuing problem of Turkey. Also, a recent study revealed that iodine excess could be a problem in newborns due to use of iodine-containing antiseptics during delivery despite maternal iodine deficiency (20).…”

Section: Introductionmentioning

confidence: 99%

Transient Congenital Hypothyroidism in Turkey: An Analysis on Frequency and Natural Course

Kara

Gunindi²,

Yılmaz³

et al. 2016

Jcrpe

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Objective: Prevalence of congenital hypothyroidism (CH) in Turkey at birth was reported to be as high as 1:650 in 2008-2010. Incidence rates of permanent and transient CH separately are unknown due to lack of follow-up data. We aimed to evaluate the impact of transient hypothyroidism on increasing incidence of CH and to determine the natural course and the clinical, biochemical, and imaging characteristics of transient CH.Methods: Baseline and follow-up data of the infants with CH detected at screening in six provinces in the Black Sea Region were analyzed retrospectively during a time period covering the years 2008-2010.Results: Among 138 cases (48% female), 16 (12%) showed transient hyperthyrotropinemia which resolved without intervention. Of the treated 122 cases, 63 (52%) had transient CH. While its frequency was 35% in 2008, it increased to 56% in 2009-2010, following a lowering of the thyroid stimulating hormone cutoff value. The frequency was higher in inland provinces than in coast (67% vs. 43%; p=0.01).Clinical characteristics of permanent and transient cases were similar except female-to-male sex ratios (1.5:1 vs. 0.6:1; p=0.02). L-thyroxine was discontinued in 70% of transient cases before 3 years of age at a median age of 19 (2-36) months. The only indication for early discontinuation of treatment was a low L-thyroxine dose, which was 1.25±0.27 µg/kg/day at withdrawal time.Conclusion: Our regional follow-up data showed that more than half of newborns with primary CH had transient thyroid dysfunction. In the majority of cases, discrimination between transient and permanent CH can be made before age 3 years, as indicated by cessation of L-thyroxine treatment.

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Section: Introductionmentioning

confidence: 99%

Transient Congenital Hypothyroidism in Turkey: An Analysis on Frequency and Natural Course

Kara

Gunindi²,

Yılmaz³

et al. 2016

Jcrpe

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“…However, several studies on neonatal TSH levels and congenital hypothyroidism (CH) have yielded conflicting results . For example, in a study investigating the role of iodine deficiency in the aetiology of CH, we found that the frequency of iodine deficiency was 36% in CH patients and 88% in their mothers .…”

Section: Introductionmentioning

confidence: 99%

“…The median values of UIC in patients and their mothers were 110 and 40 μg/l, respectively. Another recent study on cord blood TSH has found a high frequency (28%) of elevated TSH concentrations . Although the results of national CH screening, implemented by the Ministry of Health since 2007, have not yet been published, the data from several studies on regional CH screening indicate that iodine deficiency may still be a public health problem in some regions in Turkey …”

Section: Introductionmentioning

confidence: 99%

Iodine deficiency in pregnant women in the apparently iodine‐sufficient capital city of Turkey

Kutlu

Kara

2012

Clinical Endocrinology

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Our study shows that iodine deficiency is a serious problem among pregnant women in Ankara. These data confirm that iodine nutritional status among SAC does not reflect the iodine supply for pregnant women. We propose that nationwide surveillance studies should urgently be performed to directly assess and monitor the iodine status of pregnant women. We also consider that pregnant women in Turkey should be supplemented by iodine-containing preparations in addition to iodized salt.

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“…In Turkey, there are several previous regional studies based on CH screening and neonatal TSH levels (23,24,25,26,27). In a study on incidence of CH in the West Black Sea area (Bolu, Düzce, and Zonguldak provinces), elevated blood TSH (>5 mIU/L) concentrations were 26.7% and recall rate was 1.6% between 2000 and 2002 (24).…”

Section: Discussionmentioning

confidence: 99%

“…In another study from Bursa province, between 1995 and 2004, Sağlam et al (25) reported a 5.8% recall rate and a 1/840 CH incidence, which could be explained by existence of ID. Another study on cord blood TSH of newborns showed a high frequency of elevated TSH concentrations (frequency of >10 mIU/L 28%) (26). In another recent study investigating the role of ID in the etiology of CH, ID frequency was 36% in CH patients and 88% in their mothers (27).…”

Section: Discussionmentioning

confidence: 99%

Neonatal Thyroid-Stimulating Hormone Screening as a Monitoring Tool for Iodine Deficiency in Turkey

Çaylan¹,

Tezel²,

Özbaş³

et al. 2016

Jcrpe

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Objective:Thyroid-stimulating hormone (TSH) level in neonates is recommended as an indicator for presence of iodine deficiency (ID) at a population level and as a monitoring tool in programs of iodine supplementation. The purpose of this study, based on data from the National Newborn Screening Program (NNSP) for congenital hypothyroidism (CH) in 2014, was to analyze neonatal TSH levels to predict the current status of iodine nutrition in Turkey.Methods:According to screening methodology, heel-prick blood samples of newborns were collected on filter paper cards usually on day 3-5 after birth (or shortly before discharge). Results of samples collected >48 h after birth were analyzed. The degree of severity of ID was assessed by using the epidemiologic criteria of the World Health Organization (WHO). Elevated TSH levels (>5 mIU/L) were processed and classified according to province, region, birth season, and sampling time.Results:A total of 1,298531 newborns were registered in the NNSP for the CH database. Of those, 1,270311 newborns had screening results collected >48 h after birth and were included in the statistical analyses. The national prevalence of elevated TSH was 7.2%. While the Gaziantep sub-region had the highest TSH elevation rate (15.9%), the Tekirdağ sub-region had the lowest rate (4.0%; p<0.001). Seasonal variations were also significant, and the elevated TSH prevalence rate was highest in winter (7.4%; p<0.001).Conclusion:National CH screening results suggest that Turkey may still be mildly iodine deficient. Nationwide studies should be performed for direct assessment and monitoring of iodine status in vulnerable populations to confirm accuracy of our results.

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Cord blood thyroid‐stimulating hormone and free T₄ levels in Turkish neonates: Is iodine deficiency still a continuing problem?

Cited by 12 publications

References 28 publications

Transient Congenital Hypothyroidism in Turkey: An Analysis on Frequency and Natural Course

Transient Congenital Hypothyroidism in Turkey: An Analysis on Frequency and Natural Course

Iodine deficiency in pregnant women in the apparently iodine‐sufficient capital city of Turkey

Neonatal Thyroid-Stimulating Hormone Screening as a Monitoring Tool for Iodine Deficiency in Turkey

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Cord blood thyroid‐stimulating hormone and free T4 levels in Turkish neonates: Is iodine deficiency still a continuing problem?

Cited by 12 publications

References 28 publications

Transient Congenital Hypothyroidism in Turkey: An Analysis on Frequency and Natural Course

Transient Congenital Hypothyroidism in Turkey: An Analysis on Frequency and Natural Course

Iodine deficiency in pregnant women in the apparently iodine‐sufficient capital city of Turkey

Neonatal Thyroid-Stimulating Hormone Screening as a Monitoring Tool for Iodine Deficiency in Turkey

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Cord blood thyroid‐stimulating hormone and free T₄ levels in Turkish neonates: Is iodine deficiency still a continuing problem?