Neonatal screening: 9% of children with filter paper thyroid-stimulating hormone levels between 5 and 10 μIU/mL have congenital hypothyroidism

Christensen-Adad, Flávia Corrêa; Mendes‐dos‐Santos, Carolina T.; Goto, Maura Mikie Fukujima; Sewaybricker, Letícia Espósito; D’Souza-Li, Lília; Guerra‐Júnior, Gil; Morcillo, André Moreno; Lemos-Marini, Sofia Helena Valente de

doi:10.1016/j.jped.2017.05.003

Cited by 11 publications

(8 citation statements)

References 28 publications

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“…Of note, several NSPs have established their neoTSH cutoff values based on the recommendation of collecting blood in filter paper between the third and fifth days of life. However, we observed in our country that the sample collection and analysis take a longer time, hindering proper interpretation of the results (18,33). In our results, less than half of the study population was screened within the recommended lifespan, probably due to poor staff training and public transport, which could be a potential limitation.…”

Section: Epidemiological Profile Of Congenital Hypothyroidismmentioning

confidence: 60%

“…Table 4 shows the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of different cutoff values for neoTSH in the study cohort. The NSP of Campinas University (Unicamp) reported a prevalence of CH of 9.13% based on neoTSH values ranging between 5-10 mIU/L (18). In Sergipe, the total incidence of CH was 1:3,461 (19), and in the state of Mato Grosso, the incidence was 1:2,234 screened newborns (15), using neoTSH cutoff values of 5.2 and 5.0 mIU/L, respectively.…”

Section: Epidemiological Profile Of Congenital Hypothyroidismmentioning

confidence: 99%

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Epidemiological profile of congenital hypothyroidism at a southern Brazilian state

Boff¹,

Kopacek²,

Souza³

et al. 2023

Archives of Endocrinology and Metabolism

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Objective: To determine the incidence of congenital hypothyroidism (CH) over a 10-year period at the Reference Service in Neonatal Screening of the state of Rio Grande do Sul (RSNS-RS). Subjects and methods: Historical cohort study including all newborns screened for CH by the RSNS-RS from January 2008 until December 2017. Data of all newborns with neonatal TSH (neoTSH; heel prick test) values ≥ 9 mIU/L were collected. According to neoTSH values, the newborns were allocated into two groups: Group 1 (G1), comprising newborns with neoTSH ≥ 9 mIU/L and serum TSH (sTSH) < 10 mIU/L, and Group 2 (G2), comprising those with neoTSH ≥ 9 mIU/L and sTSH ≥ 10 mIU/L. Results: Of 1,043,565 newborns screened, 829 (0.08%) had neoTSH values ≥ 9 mIU/L. Of these, 284 (39.3%) had sTSH values < 10 mIU/L and were allocated to the G1 group, while 439 (60.7%) had sTSH ≥ 10 mIU/L and were allocated to the G2 group, and 106 (12.7%) were considered missing data. The overall incidence of CH was 42.1 per 100,000 newborns screened (95% confidence interval [CI] 38.5-45.7/100,000) or 1:2377 screened newborns. The sensibility and specificity of neoTSH ≥ 9 mIU/L were 97% and 11%; of neoTSH 12.6 mUI/L, 73% and 85% respectively. Conclusion: In this population, the incidence of permanent and transitory CH was 1:2377 screened newborns. The neoTSH cutoff value adopted during the study period showed excellent sensibility, which matters for a screening test.

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Section: Epidemiological Profile Of Congenital Hypothyroidismmentioning

confidence: 60%

Section: Epidemiological Profile Of Congenital Hypothyroidismmentioning

confidence: 99%

Epidemiological profile of congenital hypothyroidism at a southern Brazilian state

Boff¹,

Kopacek²,

Souza³

et al. 2023

Archives of Endocrinology and Metabolism

View full text Add to dashboard Cite

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“…However, this percentage is very likely overestimated given that that the number of days from birth to blood collection has a great influence. These data are important, as it should be borne in mind that a high percentage of the 9% of newborns with TSH values between 5–10 mIU/L may eventually present congenital hypothyroidism and it is, therefore, important to establish a cut-off point and a fixed day of age at sampling, or changing values according to days from birth to sample collection [27–29].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with moderate neonatal hyperthyrotropinemia

et al. 2019

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Background Maternal iodine deficiency is related to high neonatal thyroid-stimulating hormone (TSH) values, with the threshold of 5 mIU/L recommended as an indicator of iodine nutrition status. The objective of this study was to analyse possible risk factors for increased TSH that could distort its validity as a marker of iodine status. The clinical relevance of this research question is that if the factors associated with iodine deficiency are known, iodine supplementation can be introduced in risk groups, both during pregnancy and in newborns. Methods A case-control study was carried out in a sample of 46,622 newborns in 2002–2015 in Spain. Of these, 45,326 had a neonatal TSH value ≥5 mIU/L. The main variable was having TSH ≥5 mIU/L and the secondary variables were: sex, gestational age, day of sample extraction and maternal origin. Associated factors were analysed through a logistic regression model, calculating the odds ratio (OR). Results The factors associated with this outcome were: male sex (OR = 1.34, 95% CI: 1.20–1.50, p<0.001), originating from an Asian/Oceanic country (OR = 0.80, 95% CI: 0.54–1.20, p = 0.536) or Europe (OR = 0.80, 95% CI: 0.66–0.96, p = 0.285) (including Spain, OR = 1) [p<0.001 for America (OR = 0.54, 95% CI: 0.44–0.68) and p = 0.025 for Africa (OR = 0.78, 95% CI: 0.62–0.97)] and fewer days from birth to sampling (OR = 0.80, 95% CI: 0.77–0.82, p<0.001). Conclusions The risk of high neonatal TSH without congenital hypothyroidism is higher in males, decreases with a greater number of days from birth to extraction, and is dependent on maternal ethnicity but not on gestational age.

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“…In 2018, Kilberg et al suggested that US neonatal screening programs were missing newborns with mild and persistent TSH elevations, who could have CH and its health consequences, due to the lack of adequate standardization of TSH values [15]. Christensen-Adad PLOS ONE et al (2017) also demonstrated that 9% of children with TSH values between and 5-10 μIU/ mL (screening test cut-off = 10 μIU/mL), who did not normalize these values over time, had CH that would not have been diagnosed by the national recommended cut-off value [16].…”

Section: Introductionmentioning

confidence: 99%

Neonatal thyrotropin levels and auditory neural maturation in full-term newborns

et al. 2021

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Objective This study aimed to look for a possible relationship between thyrotropin (TSH) values from neonatal bloodspot screening testing and newborn lower auditory pathway myelinization evaluated using the brainstem evoked response audiometry (ABR) test. Methods Sixty-two healthy full-term newborns without perinatal problems were enrolled in the study. TSH results were collected from neonatal bloodspot screening data and were below the test cut-off level (15μUI/mL). The TSH test was performed between three and seven days, and the ABR test was performed in the first 28 days of life. The newborns were divided into two groups: Group 1 (n = 35), TSH between 0 and 5μUI/mL, and group 2 (n = 27), TSH between 5 and 15μUI/mL. Data are presented as mean ± SD, median, or percentage, depending on the variable. Results Wave latency and interpeak interval values for Groups 1 and 2 were as follows: Wave I: 1.8 ± 0.1 and 1.7 ± 0.1; Wave III: 4.4 ± 0.1 and 4.4 ± 0.1; Wave V: 6.9 ± 0.1 and 6.9 ± 0.1; interval I–III: 2.6 ± 0.1 and 2.6 ± 0.1; interval I–V: 5.1 ± 0.1 and 5.1 ± 0.1; interval III–V: 2.4 ± 0.1 and 2.4 ± 0.1. There were no significant differences in ABR parameters between groups 1 and 2 (p > 0.05). Multiple regression analysis showed a slight significant negative correlation between TSH and wave I values (standardized β = −0.267; p = 0.036), without observing any relationship with the other ABR waves recorded. Conclusions This study investigated the relationship of TSH and auditory myelinization evaluated by ABR. It did not show a significant change in lower auditory pathway myelinization according to TSH levels in newborns with TSH screening levels lower than 15 μUI/mL.

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Neonatal screening: 9% of children with filter paper thyroid-stimulating hormone levels between 5 and 10 μIU/mL have congenital hypothyroidism

Cited by 11 publications

References 28 publications

Epidemiological profile of congenital hypothyroidism at a southern Brazilian state

Epidemiological profile of congenital hypothyroidism at a southern Brazilian state

Factors associated with moderate neonatal hyperthyrotropinemia

Neonatal thyrotropin levels and auditory neural maturation in full-term newborns

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