Need for neonatal screening program in India: A national priority

Sareen, Neha; Pradhan, Ritu

doi:10.4103/2230-8210.149315

Cited by 8 publications

(6 citation statements)

References 64 publications

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“…Congenital hypothyroidism (CH) is the most common preventable cause of mental retardation with a global incidence of 1:2500–1:4000 live births. [ 1 2 3 4 ] Clinical diagnosis is difficult at birth, and the time of initiation of therapy is a critical determinant of outcome. Screening for early diagnosis of CH is mandatory in most of the developed countries for early diagnosis and treatment.…”

Section: Introductionmentioning

confidence: 99%

Effect of maternal and neonatal factors on cord blood thyroid stimulating hormone

Lakshminarayana¹,

Sadanandan²,

Mehaboob³

et al. 2016

Indian J Endocr Metab

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Background:Congenital hypothyroidism (CH) is most common preventable cause of mental retardation in children. Cord blood Thyroid Stimulating Hormone (CBTSH) level is an accepted screening tool for CH.Objectives:To study CBTSH profile in neonates born at tertiary care referral center and to analyze the influence of maternal and neonatal factors on their levels.Design:Cross retrospective sectional study.Methods:Study population included 979 neonates (males = 506 to females = 473). The CBTSH levels were estimated using electrochemiluminescence immunoassay on Cobas analyzer. Kit based cut-offs of TSH level were used for analysis. All neonates with abnormal CBSTH levels, were started on levothyroxine supplementation 10 μg/Kg/day and TSH levels were reassessed as per departmental protocol.Results:The mean CBTSH was 7.82 μIU/mL (Range 0.112 to 81.4, SD = 5.48). The mean CBTSH level was significantly higher in first order neonates, neonates delivered by assisted vaginal delivery and normal delivery, delivered at term or preterm, neonates with APGAR score <5 and those needing advanced resuscitation after birth. The CBTSH level >16.10 and <1.0 μIU/mL was found in 4.39 % and 1.02 % neonates respectively. The prevalence rate of CBTSH level >16.1 μIU/mL was significantly higher in neonates delivered by assisted vaginal delivery and normal delivery, term and preterm neonates, APAGR score of <5, presence of fetal distress, need for resuscitation beyond initial steps and in those with birth weight of <1.5 Kg. Three neonates were confirmed to have CH after retesting of TSH level.Conclusions:The CBTSH estimation is an easy, non-invasive method for screening for CH. The cutoff level of CB TSH (μIU/mL) >16.10 and <1.0 led to a recall of 5.41% of neonates which is practicable given the scenario in our Country. The mode of delivery and perinatal stress factors have a significant impact on CBTSH levels and any rise to be seen in the light of these factors. The prevalence rate of CH after recall was ~3 in 1000 live births.

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Section: Introductionmentioning

confidence: 99%

Effect of maternal and neonatal factors on cord blood thyroid stimulating hormone

Lakshminarayana¹,

Sadanandan²,

Mehaboob³

et al. 2016

Indian J Endocr Metab

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“…The average age at diagnosis for children with short alone was 7.3 years which was later than any other symptom as parents presumed that growth would eventually occur. As there is no national program in India for diagnosis of CH at present, neonatal detection of ET in the community is not easy [20].…”

Section: Discussionmentioning

confidence: 99%

“…Indian J Child Health 159 20 min after intravenous injection of 1 mci of 99mTc pertechnetate. Any focal tracer uptake along the midline from the tongue to the suprasternal notch, either isolated or in addition to the normal gland, was identified as ET.…”

Section: Vol 8 | Issue 4 | April 2021mentioning

confidence: 99%

Clinical, diagnostic, and follow-up characteristics of children with ectopic thyroid: An 11-year tertiary referral center experience

Saidalikutty¹,

Raghupathy²,

Narasimhan³

et al. 2021

Indian J Child Health

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T hyroid dysgenesis is the most common cause of permanent congenital hypothyroidism (CH) and it comprises ectopia, hypoplasia, agenesis, or hemi-agenesis of the thyroid gland [1]. Ectopic thyroid (ET) is an aberrancy of the thyroid embryogenesis during its passage from the floor of the primitive foregut to the final anatomical position in the pre-tracheal position and accounts for 49-61% of the thyroid dysgenesis [2,3]. The prevalence of ET in other populations is 1 in 100,000 to 300,000 [3][4][5]. The clinical information on the spectrum of manifestations of ET in South Indian children is scanty [1]. Understanding the clinical profile of the various types of ET and the response to treatment helps the optimization of the clinician's approach to the patient. Hence, this study was undertaken to analyze the clinical, biochemical, and scintigraphy characteristics among children presenting with ET and their clinical and biochemical response to treatment. METHODSThis retrospective observational study was conducted in a single tertiary hospital. The case records of all infants and children diagnosed with ET and treated between January 2005 and March 2016 in the department of Pediatric Endocrinology at our center were studied. Most of the cases were referred to the specialist center seeking treatment, while a few were infants diagnosed at birth in this hospital. Physical examination of thyroid gland included search in its normal position or in the known ectopic sites-front of the neck or lingual. All infants and children with abnormal thyroid function tests (TFTs) at initial presentation had scintigraphy done before initiation of thyroxine (T4) therapy to establish the etiology and to confirm permanent hypothyroidism.Gamma camera was used for nuclear scan to obtain static planar images of head and neck regions in anterior projection ABSTRACT Background: Information on the clinical data and follow-up of ectopic thyroid (ET) in pediatric population in India is scanty; hence, this study aims to add more information on this entity. Objective: This study was undertaken to analyze the clinical, biochemical characteristics, and scintigraphy findings at diagnosis and follow-up response to thyroxine (T4) replacement in children with ET. Methods: This study was conducted at the Paediatric Endocrinology Department of Tertiary Center from January 2005 to March 2016. In children with abnormal thyroid function, scintigraphy was done before T4 replacement to establish the diagnosis of permanent congenital hypothyroidism. Thyroid dose modification, growth monitoring was done on follow-up. In infants and children without an etiological diagnosis, at ≥3 years of age, thyroid function test, scintigraphy was done after stopping treatment for 4 weeks. The initial clinical, biochemical parameters, follow-up data were analyzed. Results: Among 54 children with ET, 39 (72.2%) were girls. The mean age of presentation was 3.3 years and the average age at diagnosis on the basis of presentation with isolated short stature was 7.3 years. Developmenta...

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“…The neurologic impairment happens primarily in the second trimester, which is a vital period for formation of the cerebral cortex, the extrapyramidal system, and the cochlea, areas damaged in endemic cretins [42]. Iodine deficiency in fetus results in miscarriages, stillbirths, brain disorders, retarded psychomotor development, speech and hearing impairments [43]. Iodine deficiency in infants can damage the developing brain and increase mortality [44].…”

Section: Maternal Iodine Deficiencymentioning

confidence: 99%

Maternal Iodine Deficiency and Brain Disorders

Rg¹

2016

Endocrinol Metab Syndr

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Thyroid Hormones (THs) play an essential role in development and hormone deficiency during critical phases in fetal life may lead to severe and permanent brain damage. Maternal iodine deficiency is considered the most common cause of fetal TH deficiency, but the problem may also arise in the fetus/neonates. Due to defects in fetal thyroid gland development or hormone synthesis, clinical symptoms at birth are often mild as a result of compensatory maternal TH supply. A shortage of THs starting at the early stages of pregnancy results in neurological deficits that cannot be rescued by exogenous TH addition at later stages. Neonates are more sensitive than adults to the effects of iodine deficiency. Thus, these disturbances may lead to abnormalities in the neuronal network and may result in mental retardation and other neurological defects, including impaired motor skills and visual processing. Thus, iodine defenses programmes can avoid adverse neurodevelopmental consequences in mothers and their offspring.

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Need for neonatal screening program in India: A national priority

Cited by 8 publications

References 64 publications

Effect of maternal and neonatal factors on cord blood thyroid stimulating hormone

Effect of maternal and neonatal factors on cord blood thyroid stimulating hormone

Clinical, diagnostic, and follow-up characteristics of children with ectopic thyroid: An 11-year tertiary referral center experience

Maternal Iodine Deficiency and Brain Disorders

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