Screening for congenital hypothyroidism in Hong Kong

Low, Lck; Lin, Hsiang‐Ju; Cheung, PT; Lee, F. T.; Chu, Shao‐Yin; Kwok, Thomas; Bacon‐Shone, John; Yeung, Ching‐Hei

doi:10.1111/j.1440-1754.1986.tb00184.x

Cited by 11 publications

(15 citation statements)

References 21 publications

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“…In India an estimated 10,000 babies are born with congenital hypothyroidism every year [7,8]. Recently, countries like Philippines and China too have commenced the screening because waiting for a symptomatic diagnosis of affected infants mean the baby will NEVER be normal [9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of CHT has been reported to vary between 1:3000 to 1:5000 live births, in most parts of the world [8,[10][11][12]. In India, the incidence of CHT is thought to be much higher although published reports have been limited and have been done prior to the availability of diagnostic methods such as nuclear scans for detection of thyroid gland which have increased the precision of the diagnosis [14][15][16].…”

Section: Discussionmentioning

confidence: 99%

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Newborn Screening for Congenital Hypothyroidism in India– Is OVERDUE

Fletcher¹

2014

J Neonatal Biol

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Neonatal screening is an essential preventative public health program, and is the standard practice of care worldwide. India is yet to start any publicly funded program despite this having been established in many countries for over 50 years. The purpose of neonatal screening is to reduce morbidity and mortality in the newborn. Detection must have a clear benefit for the baby and be cost effective when compared to the cost associated with delayed treatment. These criteria are clearly satisfied for screening a baby at birth for congenital hypothyroidism (CHT). Though systematic neonatal screening for congenital hypothyroidism was introduced in the early 1970 in many countries, in India an estimated 10,000 babies are born with congenital hypothyroidism every year, yet there is no screening program for this. We present the details of our study, which reveals that CHT in India has a high incidence and is an URGENT high priority for public screening.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Newborn Screening for Congenital Hypothyroidism in India– Is OVERDUE

Fletcher¹

2014

J Neonatal Biol

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“…The experience in Hong Kong, where iodine intake is of marginal or borderline sufficiency, suggests that monitoring schoolchildren alone is not adequate to prevent ID in pregnant and lactating women and their offspring. In Hong Kong, a special administrative region in southern China, the median UI in schoolchildren was above 100 mg l 21 and less than 20% of urine samples had an iodine concentration below 50 mg per l 11,12 . The total goitre rate among the schoolchildren was 3% 13 .…”

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confidence: 99%

“…However, neonatal screening has shown that the median cord blood TSH is 5.6 mIU l 21 and 22% of the cord blood samples had a TSH concentration of . 10 mIU per l 14 . The incidence of neonatal hypothyroidism was 1 in 3300 and 23% of cases of congenital hypothyroidism were transient in nature 14 .…”

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Iodine nutrition of pregnant and lactating women in Hong Kong, where intake is of borderline sufficiency

Kung

2007

Public Health Nutr.

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Objective: To describe the iodine nutrition of pregnant and lactating women in Hong Kong, where intake is of borderline sufficiency. Design: Review of cross-sectional and prospective studies. Setting: China, Hong Kong Special Administrative Region (SAR). Subjects: Pregnant and lactating women. Results: Studies of pregnant women in Hong Kong SAR have revealed an increase in the urinary iodine (UI) concentration as pregnancy advances. A significant percentage of women had a sub-normal serum thyroid hormone concentration at full term. Although iodine is concentrated by the mammary gland, 19% of all mothers had low iodine concentrations in their breast milk. The moderate correlation between the concentrations of iodine in breast milk and urine suggests that an adequate maternal urinary iodine concentration cannot reliably indicate that an infant is getting enough iodine in breast milk. Therefore, some breast-fed infants may still be at risk of low iodine intake, and additional iodine supplements, other than salt iodisation, would be warranted in this population. Conclusions:The currently recommended intake of iodine through universal salt iodisation may not be adequate for pregnant and lactating women, and supplementation during pregnancy and lactation should be further considered in light of the latest recommendations. KeywordsIodine Deficiency Pregnancy Lactation Urinary iodine Hong KongAn adequate iodine intake during pregnancy and lactation is important because both the foetus and the neonate are particularly vulnerable to the harmful effects of deficiency. The clinical consequences of severe iodine deficiency (ID) are easily recognised, but the effects of mild to moderate deficiency are often overlooked: thyroid enlargement in both the mother and the neonate, and hypothyroidism, hyperthyrotropinaemia and impaired neuropsychological development of the neonate 1 . In localities in which the iodine intake of the general population is adequate because of complete or partial salt iodisation programmes, the problem of ID in pregnant and lactating women, and hence in neonates, is minimal. Even in countries with a recently introduced but well-monitored salt iodisation programme, such as China, the goitre rate is low at about 5%, and the median urinary iodine (UI) concentrations of women of reproductive age and those who are pregnant and lactating indicate an adequate iodine nutrition 2 . This suggests that salt iodisation can prevent ID not only in schoolchildren, but also in pregnant mothers and their neonates. A randomised controlled study in China confirmed that infants born to mothers supplemented with iodised salt had significantly better gross motor function, language skills and development quotient, and that the percentage of infants born with a sub-normal development quotient was significantly lower than in controls 3 . A study in an area with an effective salt iodisation programme among the general population found that infants born with a concentration of thyroid-stimulating hormone (TSH) in cord bloo...

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Newborn screening in the Asia Pacific region

Padilla

Therrell

2007

J of Inher Metab Disea

127

102

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The success of blood spot newborn screening in the USA led to early screening efforts in parts of the Asia Pacific Region in the mid-1960s. While there were early screening leaders in the region, many of the countries with depressed and developing economies are only now beginning organized screening efforts. Four periods of screening growth in the Asia Pacific region were identified. Beginning in the 1960s, blood spot screening began in New Zealand and Australia, followed by Japan and a cord blood screening programme for G6PD deficiency in Singapore. In the 1980s, established programmes added congenital hypothyroidism and new programmes developed in Taiwan, Hong Kong, China (Shanghai), India and Malaysia. Programmes developing in the 1990s built on the experience of others developing more rapidly in Korea, Thailand and the Philippines. In the 2000s, with limited funding support from the International Atomic Energy Agency, there has been screening programme development around detection of congenital hypothyroidism in Indonesia, Mongolia, Sri Lanka, Myanmar and Pakistan. Palau has recently contracted with the Philippine newborn screening programme. There is little information available on newborn screening activities in Nepal, Cambodia, Laos and the other Pacific Island nations, with no organized screening efforts apparent. Since approximately half of the births in the world occur in the Asia Pacific Region, it is important to continue the ongoing implementation and expansion efforts so that these children can attain the same health status as children in more developed parts of the world and their full potential can be realized.

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Screening for congenital hypothyroidism in Hong Kong

Cited by 11 publications

References 21 publications

Newborn Screening for Congenital Hypothyroidism in India– Is OVERDUE

Newborn Screening for Congenital Hypothyroidism in India– Is OVERDUE

Iodine nutrition of pregnant and lactating women in Hong Kong, where intake is of borderline sufficiency

Newborn screening in the Asia Pacific region

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