Prediction of congenital hypothyroidism based on initial screening thyroid-stimulating-hormone

Saleh, David; Lawrence, Sarah; Geraghty, Michael T.; Gallego, Patricia; McAssey, Karen; Wherrett, Diane K.; Chakraborty, Pranesh

doi:10.1186/s12887-016-0559-0

Cited by 34 publications

(26 citation statements)

References 23 publications

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“…Congenital hypothyroidism (CH) includes all conditions in which exist insufficient function of the thyroid gland, regardless of etiology, and is clinically or laboratory detected at birth. The incidence of CH of 1:1,500 is comparable to reports in other jurisdictions (1,2). The disease is twice as common in female children.…”

Section: Introductionsupporting

confidence: 79%

Hypothyroidism in Pediatric Population - Bosnian and Herzegovinian Situation

Hasanbegović

Begić

2017

Med Arch

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Introduction:Thyroid gland diseases in children are in second place by frequency among all endocrine disorders. When interpreting the results of the thyroid function assessment it should be taken into account the significant differences in the concentrations of TSH, thyroid hormones, thyroid binding proteins and calcitonin among children of different ages.Goal:To present the age and sex structure of the patients diagnosed with hypothyroidism, evaluate diagnostic methods for making diagnosis, evaluation of etiology of hypothyroidism, with special review of the therapeutic modality.Patients and methods:The study have retrospective character and includes all patients who have the diagnosis of hypothyroidism, but at the moment of data collection were aged 0-18 years.Results:Distribution of patients on the basis of gender, revealed more significant representation of female (65.93%), and without significant difference in the presence of the disease in relation to age (p>0.05). Physical examination of the struma was not verified in the majority of cases (74; 81.32%, p<0.05) suffering from hypothyroidism. Ultrasound review in 22 (50%) cases confirmed the struma. Ultrasound findings in most cases 14 (31.81%) demonstrated diffuse struma and Hashimoto thyroiditis together. In relation to the etiology of hypothyroidism most patients belong to a group where hypothyroidism is associated with other diseases and conditions (27; 29.67%), but the least with congenital hypothyroidism with 18 (19.78%) cases. The average dose of L-thyroxine in the age of 0-1 months was 50 mg, 1 month–10 years 37.5 mcg, and the group of patients over 10 years 65 mcg.Conclusion:Congenital hypothyroidism has about one-fifth of patients. Physical examination revealed in about one fifth of patients the struma of the thyroid gland; TSH levels is critical for the diagnosis and correction of therapy in pediatric patients with hypothyroidism. Congenital hypothyroidism is diagnosed on average at the age of 12 days, which is optimal for period for therapeutic response; Substitution treatment is carried out with L-thyroxine which is relatively reduced in doses from neonatal age onwards.

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Section: Introductionsupporting

confidence: 79%

Hypothyroidism in Pediatric Population - Bosnian and Herzegovinian Situation

Hasanbegović

Begić

2017

Med Arch

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“…However, very few of our participants had clinically elevated TSH (0.4%) while more had clinically low TSH (6.3%). Thus, we had very little data to examine whether clinically elevated TSH, a generally rare (occurring in approximately 1:1,000 newborns) but strong predictor of congenital hypothyroidism, was associated with ASD [Hinton et al, ; Saleh et al, ]. Causes of atypically low TSH are diverse, with presentations in hyperthyroid or, more rarely, in hypothyroid disorders possibly due to a dysfunctional feedback loop [Rose et al, ].…”

Section: Discussionmentioning

confidence: 99%

Neonatal Thyroid Stimulating Hormone and Subsequent Diagnosis of Autism Spectrum Disorders and Intellectual Disability

et al. 2019

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Hypothyroid conditions in early life, if left untreated, are associated with adverse neurodevelopmental outcomes, including intellectual disability (ID). However, evidence addressing the role of neonatal thyroid hormone insufficiencies in the altered neurobiology underlying autism spectrum disorders (ASD), particularly among its subphenotypes, is limited. We conducted a population‐based, case–control study among a sample of children born during 2000–2003 in Southern California. We examined neonatal thyroid‐stimulating hormone (TSH) measured during routine newborn screening among children later diagnosed with ASD (n = 518) or ID (n = 145) and general population (GP) controls (n = 399). TSH was further analyzed in relation to ASD subgroups of intellectual ability and onset type (early‐onset ASD vs. ASD with regression) ascertained by expert review of developmental services records. Odds ratios (ORs) of the differences in TSH between groups were obtained from multivariate logistic regression. We examined neonatal TSH as continuous (ln‐transformed) and as quartiles. We found no association between continuous neonatal TSH levels and ASD (adj‐OR: 1.00, 95% CI: 0.79–1.26) nor ID (adj‐OR = 1.01, 95% CI: 0.73–1.40). Among ASD subphenotypes, we observed a suggestive inverse trend between ASD with regression and TSH, though the association only reached statistical significance in the highest TSH quartile (adj‐OR: 0.50, 95% CI: 0.26–0.98). While there was little evidence that neonatal TSH is related to overall ASD risk, more work is needed to understand the influence of thyroid hormones on ASD subphenotypes. Autism Res 2020, 13: 444–455. © 2019 International Society for Autism Research,Wiley Periodicals, Inc. Lay Summary Low levels of thyroid hormone at birth can negatively impact brain development. We studied whether newborn levels of thyroid stimulating hormone (TSH) were associated with autism spectrum disorder (ASD) and its subtypes in a sample of children born in California. Newborn TSH was not related to the overall risk of ASD or intellectual disability. However, the relationships of thyroid hormone levels at birth and specific subtypes of ASD, particularly ASD with developmental regression, may need more research.

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“…A newborn screen for congenital hypothyroidism was considered positive if the infant filter paper TSH was > 17 μIU/ml in whole blood [20,21]. Based on the World Health Organization's (WHO) classification, maternal urine iodine concentration was further disaggregated into: severe iodine deficiency (< 20 μg/L); moderate iodine deficiency (20-49 μg/L); mild iodine deficiency (50-99 μg/L); sufficient iodine level (100-199 μg/L); above requirements (200-299 μg/L); and excessive iodine intake (> 300 μg/L).…”

Section: Definitionsmentioning

confidence: 99%

Correlating maternal iodine status with neonatal thyroid function in two hospital populations in Ghana: a multicenter cross-sectional pilot study

et al. 2020

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Background: Congenital hypothyroidism is a common, yet easily treatable cause of poor growth and intellectual disability. Newborn screening programs play an important role in the early detection and treatment of congenital hypothyroidism. However, an estimated 71% of children are born in countries such as Ghana, which does not have a screening program. Iodine deficiency, a common cause of congenital hypothyroidism, is present in the Ghanaian population. Mild to moderate maternal iodine deficiency may negatively impact cognitive function in children. A structured approach to examine the association between maternal iodine levels and infant thyroid function may have important ramifications on our understanding of congenital hypothyroidism in Ghana. We investigated the hypothesis that maternal iodine deficiency impacts infant thyroid function, using Thyroid Stimulating Hormone (TSH) as a marker of thyroid function. We also explored potential opportunities and barriers to newborn screening for congenital hypothyroidism in Ghana. Methods: This was a cross-sectional, multicenter pilot study of 250 women and their neonates recruited from postnatal clinics in Accra and Tamale, Ghana. We compared maternal urine iodine concentration and infant TSH, as well as maternal sociodemographic and nutrition information. Regression models were used to model the relationship between variables. Results: Median infant TSH was 4.7 μIU/ml (95% CI: 3.9-5.5) in Accra. In Tamale, the median infant TSH was 3.5 μIU/ml (95%CI: 3.3 to 3.6) (Δ: 1.3 μIU/ml, 95% CI: 0.5-2.1, p = 0.002). Median maternal urine iodine concentrations were 141.0 μg/L (95% CI: 115.7 to 166.3) and 142.5 μg/L (95% CI: 125.1 to 160.0) in Accra and Tamale, respectively (Δ: − 1.5 μIU/ ml, 95% CI: − 32.2-29.2, p = 0.925). There was a weakly positive correlation between maternal urine iodine and infant TSH (rho 0.1, p = 0.02). Almost one-third (30%) of women in both locations had biochemical evidence of iodine deficiency. Mothers with any formal education were more likely to have higher iodine levels than their counterparts who had no formal education (coefficient 0.31, p = 0.006). Conclusions: Maternal iodine deficiency is prevalent in Ghana and is correlated to infant thyroid function. We recommend studies with larger sample sizes to assess the true scope of this relationship.

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Prediction of congenital hypothyroidism based on initial screening thyroid-stimulating-hormone

Cited by 34 publications

References 23 publications

Hypothyroidism in Pediatric Population - Bosnian and Herzegovinian Situation

Hypothyroidism in Pediatric Population - Bosnian and Herzegovinian Situation

Neonatal Thyroid Stimulating Hormone and Subsequent Diagnosis of Autism Spectrum Disorders and Intellectual Disability

Correlating maternal iodine status with neonatal thyroid function in two hospital populations in Ghana: a multicenter cross-sectional pilot study

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