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ORIGINAL ARTICLE
Year : 2019  |  Volume : 16  |  Issue : 2  |  Page : 76-79

Cord blood thyroid-stimulating hormone as a screening tool for congenital hypothyroidism: A single-center 5-year experience


Department of Pediatrics, Pacific Medical College and Hospital, Udaipur, Rajasthan, India

Correspondence Address:
Dr. Ravi Bhatia
Associate Professor, Department of Pediatrics, Pacific Medical College and Hospital, Udaipur - 313 002, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/trp.trp_15_19

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Introduction: Congenital hypothyroidism remains one of the most common preventable causes of mental retardation in the pediatric age group. Screening for congenital hypothyroidism is one of the most cost-effective tools to prevent mental retardation among the general population. Umbilical cord blood thyroid-stimulating hormone (CB TSH) estimation remains an easily available option for screening for congenital hypothyroidism. Aim: The aim of this study was to find normative values of CB TSH for the study group and to use CB TSH levels as a screening tool for congenital hypothyroidism. Design: This study was a cross-sectional study. Setting: This study was conducted in a private medical college. Materials and Methods: CB TSH levels were measured in 2916 neonates using chemiluminescence immunoassay. All neonates who had an umbilical CB TSH level >20 mIU/ml were called back on day 7 for a repeat thyroid profile testing. Results: CB samples of 3102 neonates were tested for TSH; of them, 186 samples were hemolyzed, and hence, 2916 neonates formed the study group. Male-to-female ratio was 1544:1378, i.e., 1.2.1. The birth weights of the study group ranged between 0.8 kg and 4.76 kg, with the average birth weight being 2.9 kg. The cohort was divided into two groups: Group 1 (n = 1983) comprised of neonates who were born term and Group 2 (n = 933) comprised of neonates who were born before term gestation. TSH values ranged between 1.2 and 100 mIU/ml. The mean TSH value of the cohort was 7.17 mIU/ml. The mean TSH value in Group 1 was 6.89 mIU/ml, whereas in the Group 2, it was 7.57 mIU/ml. TSH values corresponding to the 3rd, 10th, 25th, 50th, 75th, 90th, 95th, and 97th percentile were 2.3, 2.9, 3.48, 5.4, 7.1, 10.67, 13.4, and 21.4, respectively, in Group 1, whereas TSH values corresponding to the 3rd, 10th, 25th, 50th, 75th, 90th, 95th, and 97th percentile in Group 2 were 2.32, 3.12, 4.12, 5.63, 7.65, 10.67, 13.4, and 22, respectively. Seventy neonates (2.4%) had a CB TSH value >20 mIU/ml and had to be recalled for a repeat workup. Of the 70 babies recalled for repeat testing, 59 turned up and eventually two turned out to be hypothyroid on repeat testing. The incidence of congenital hypothyroidism in our study was 1 in 1458. To conclude, we can safely use a cutoff of CB TSH >20 mIU/ml for screening for congenital hypothyroidism. Conclusion: A cut off Cord Blood TSH value > 20 IU/ml can be used for screening purpose.


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