Risk factors associated with delayed thyrotropin elevations in congenital hypothyroidism

Larson, Cecilia A.; Hermos, R J; Delaney, Ann; Daley, Denise A; Mitchell, Marvin L.

doi:10.1067/s0022-3476(03)00332-9

Cited by 116 publications

(74 citation statements)

References 16 publications

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“…12 Although more common in LBW newborns, delayed TSH increase can also occur in normal birth weight newborns. 12 Fig 11 shows the effects of LBW or delayed TSH increase to the incidence rate of CH.…”

Section: Lbw and Ch-incidence Rate: Massachusettsmentioning

confidence: 99%

“…From 1990 (when the NBS program began tracking these data) to 2007, the proportion of newborns who weighed Ͻ1500 g in the screened population increased from ϳ0.8% to 1.1% (data not shown). In 1995, responding to the observation that a significant number of LBW newborns with CH had low or normal T4 and normal TSH concentrations on the initial screen but a decreased T4 and increased TSH concentration, typical of CH, on subsequent screens, 12 the NBS program implemented a repeatspecimen policy for newborns in NICUs, particularly for those who weighed Ͻ1500 g. The policy requires all newborns in the NICU to have a second specimen collected at 2 weeks of age or at discharge, whichever is earlier. However, if a newborn's birth weight is Ͻ1500 g, specimens are required at 2, 4, 6, and 10 weeks of age or until the infant reaches a weight of 1500 g.…”

Section: Lbw and Ch-incidence Rate: Massachusettsmentioning

confidence: 99%

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Trends in Incidence Rates of Congenital Hypothyroidism Related to Select Demographic Factors: Data From the United States, California, Massachusetts, New York, and Texas

et al. 2010

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Primary congenital hypothyroidism (CH) is a common and preventable cause of intellectual disability. The incidence rate of CH has been reported to be increasing in the United States, but the factors behind the observed rate increase are not known. We summarize here the data presented at a workshop on CH, at which factors potentially related to the CH-incidence-rate increase (namely, race, ethnicity, sex, and birth outcomes) were evaluated. Data sources for the analyses included a national data set of newborn-screening results and state-specific data from newborn-screening programs in California, Massachusetts, New York, and Texas. The incidence rate of CH increased in the United States by 3% per year; however, an increase did not occur in all states, at a constant rate, or even at the same rate. Analysis of US data (1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000) showed a CH-incidence-rate increase only among white newborns. More recently, in California (2000-2007, the rate was constant in non-Hispanic newborns, but it increased among Hispanic newborns. In the national data, the CH-incidence rate increased similarly among boys and girls, whereas in Texas (1992Texas ( -2006, the rate among boys increased significantly more than among girls and varied according to race and ethnicity. In Massachusetts (1995Massachusetts ( -2007, low birth weight newborns or newborns who had a delayed rise in thyrotropin concentration accounted for the majority of the recent rate increase. Race, ethnicity, sex, and pregnancy outcomes have affected the observed increasing incidence rate of CH, although there have been some inconsistencies and regional differences. The association with preterm birth or low birth weight could reflect the misclassification of some cases of transient hypothyroxinemia as true CH. Future studies of risk factors should focus on correct initial identification and reporting of demographic characteristics and pregnancy outcomes for cases of CH. In addition, long-term follow-up data of presumed cases of CH should be ascertained to differentiate true cases of CH from cases of transient hypothyroidism.

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Section: Lbw and Ch-incidence Rate: Massachusettsmentioning

confidence: 99%

Section: Lbw and Ch-incidence Rate: Massachusettsmentioning

confidence: 99%

Trends in Incidence Rates of Congenital Hypothyroidism Related to Select Demographic Factors: Data From the United States, California, Massachusetts, New York, and Texas

et al. 2010

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“…미숙아의 이러 한 특징들로 인하여 적절한 검사 시기, 검사 횟수 및 재검시기에 대하여 많은 논란이 있다 4,[10][11][12][13][14] . 본 연구의 목적은 미숙아에서 갑상선기능이상의 빈도 및 자연경과에 대해 알아보아 향후 환자 를 진료하는데 도움을 받고자 하였다.…”

Section: 가장 흔한 것은 일시적인 저티록신혈증(Transient Hypothyroxinemia)이며 이외에도 일시적인unclassified

Thyroid dysfunction in premature infants

et al. 2009

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Purpose : Thyroid hormone is essential for development of the brain in early life. Thyroid dysfunction is more common in the first 2-4 postnatal weeks of life in premature infants than in term infants. This study aimed to identify the prevalence and clinical course of thyroid dysfunction in prematurity. Methods : Premature infants admitted to and given neonatal screenings at Dankook University Hospital between April 1999 and March 2008 were included in this study. We retrospectively reviewed medical records and categorized subjects into six groups: normal, hypothyroidism, hyperthyrotropinemia, hypothyroxinemia, delayed onset of hypothyroidism, and delayed onset of hyperthyrotropinemia. Results : Among 599 subjects, 136 (23%) had initially abnormal thyroid function test (TFT); transient hypothyroxinemia was the most frequent condition (118, 20%). In addition, 8 (17%) of 46 subjects with initially normal TFT levels showed delayed onset of hyperthyrotropinemia with or without low free thyroxine (fT4). Thyroxine was prescribed for 10 patients (1.7%) due to low fT4 levels but was discontinued in 9 patients during follow-up. Thyroid scan confirmed ectopic thyroid in one patient. Conclusion : Thyroid dysfunction was frequently seen in premature infants, but most of the conditions were transient. In addition, some infants showed delayed TSH elevation on routine follow-up. Therefore, a recheck of the thyroid function of premature infants at 3-4 weeks is recommended, even if normal thyroid function is initially seen, especially in prematurity of less than 33 weeks of gestational age or birth weight of less than 2,500 grams. (Korean J Pediatr 2009;52:991-998)

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“…Otra situación por considerar son las influencias que soporta la TSH, propias del neonato, de la madre y del medio, por lo que son motivo de estudio: el peso, la edad gestacional, el sexo, enfermedades graves y congénitas, modo de parto, gemelaridad, exposiciones a fármacos en el embarazo o período neonatal, sufrimiento fetal de diversas etiologías, enfermedades maternas y presencia de anticuerpos tiroideos. [7][8][9][10][11][12][13][14][15][16][17][18] Si bien no es el propósito de este trabajo, el estudio de niños prematuros merece una atención especial dado que el bajo peso de nacimiento ha sido señalado como un factor independiente que afecta los niveles de TSH en la pesquisa, con el agravante originado de posible sepsis, nutrición e hipoxemia. 19 La persistencia de TSH elevada en los RN de muy bajo peso (<1500g) ha permitido proponer una segunda evaluación al mes de vida en esta población, y a algunos autores preguntarse si se debería considerar un valor límite diferente para estos casos.…”

Section: Introductionunclassified

Intervalos de referencia para tirotropina sérica durante los primeros 14 días de vida

Yaniskowski

2012

Arch Argent Pediat

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Arch Argent Pediatr 2012;110(1):27-34 / 27 RESUMEN Introducción. La detección precoz del hipotiroidismo congénito evita la morbilidad física con retardo mental. En un esfuerzo para incrementar la especificidad del programa de pesquisa, nuestro objetivo fue definir intervalos de referencia para tirotropina sérica en recién nacidos (RN) de entre 2 y 14 días de vida. Población y métodos. Todos los recién nacidos (RN) de la pesquisa neonatal entre los años 2001 y 2007. Se determinó tirotropina sérica por electroquimioluminiscencia. Se excluyeron: niños con hipotiroidismo congénito confirmado, los fallecidos antes del mes, los menores de 1500 g, las muestras de otra institución, con TSH < 0,01 µU/ml y las tomadas con más de 14 días de vida. Herramientas estadísticas: pruebas t de Student, medidas de centralidad y dispersión, y transformaciones logarítmicas. Resultados. Población estudiada: 6772 RN (total 7869), el 50,48% fueron varones. La relación varón/ mujer fue similar durante los 14 días. La edad promedio al testeo fue 5,85 días (± 2,58) en el 75% de los RN, mientras que para TSH la media fue 4,42 µU/ml (± 4,17). Se encontró relación inversa entre edad y TSH (día 2 una media de 5,82 µU/ml y al día 14 de 2,58 µU/ml). Conclusión. Se encuentra evidencia estadísti-ca de relación negativa entre TSH y edad del RN. Los intervalos de referencia desarrollados para TSH contribuyen a una mejor evaluación del estado tiroideo en el RN y ayudan a definir una conducta terapéutica individual apropiada. Palabras clave: tirotropina sérica, intervalos de referencia, período neonatal. SUMMARY Introduction.Early detection of congenital hypothyroidism (CH) prevents impaired cognitive and motor development at problems. To increase the screening program specificity, we defined reference intervals for serum TSH in newborns between 2 and 14 days of life. Patients and methods. Newborn infants from our neonatal screening program between 2001 and 2007. Serum TSH was determined by electrochemiluminescence. There were excluded neonates who died before the first month of life or with less than 1500 grams at birth, samples with TSH <0,01 µU/ml., processed after 14 days of life and from other medical centers. Statistical tools: Student t-tests, measures of centrality and dispersion, and logarithmic transformations. Results. Studied population: 6772 newborn infants out of 7869, 50.49% were males. The male/ female ratio was similar during the 14 days. The mean age at testing was 5.85 days (± 2.58), and the mean of TSH value was 4.42 µU/ml (± 4.17). Inverse relationship was found between age and TSH (mean TSH at days 2 and 14 was 5.82 µU/ ml and 2.58 respectively). Conclusion. We found statistical evidence on an inverse relationship between TSH and age in newborn infants whit 14 days of age. Reference intervals for TSH contribute to a better assessment of thyroid status in neonates and to define an appropriate conduct for individual therapy.

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Risk factors associated with delayed thyrotropin elevations in congenital hypothyroidism

Cited by 116 publications

References 16 publications

Trends in Incidence Rates of Congenital Hypothyroidism Related to Select Demographic Factors: Data From the United States, California, Massachusetts, New York, and Texas

Trends in Incidence Rates of Congenital Hypothyroidism Related to Select Demographic Factors: Data From the United States, California, Massachusetts, New York, and Texas

Thyroid dysfunction in premature infants

Intervalos de referencia para tirotropina sérica durante los primeros 14 días de vida

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