Laboratory Evaluation of Serum TSH Levels in Neonates Born in Tertiary Care Hospital of Northern India (original) (raw)
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The Study on Thyroid Status among Newborns in Jaffna District in Sri Lanka
Procedia Food Science
Iodine is an essential nutrient for the production of thyroid hormones triiodothyronine (T3) and thyroxine (T4). A woman needs more iodine during pregnancy to maintain normal metabolism as well as to meet the requirements of T4 and iodide transfer to the fetus. Objective of this study was to assess the thyroid status among newborns in Jaffna District, because similar studies conducted nationally, but not in Jaffna and no data is available about the thyroid status of the neonates. Randomly selected 477 newborns in six Medical Officers of Health (MOH) Divisions out of twelve were studied.Blood spots were taken from the neonates within the one week of delivery on specified filter paper and thyroid stimulating hormone (TSH) was assayed by using enzyme-linked immunosorbent assay(ELISA)/Radioimmunoassay (RIA) technique depending on availability of the kits in the laboratory. Among the total newborns, 239 were males (50.5%). Mean birth weight (BW) of them was 3031.5(±432.6) g, while the mean length was 51.1 (±2.1) cm. BW of males ranged from 1.7 to 5.0 Kg and of females from 1.5 to 4.35 Kg. Length of the newborns ranged from 45.0 to 58.0 cm for males and from 44.0 to 57.0 cm for females. The low birth weight (LBW), normal birth weight (NBW) and higher birth weight (HBW) were 11.3 (n=54), 88.5 (n=422) and 0.2 % (n=1) respectively. Mean neonatal blood spot TSH concentration was 9.8 (±2.1) mIU/L, and ranged from 1.00 to 53.46 mIU/L. Neonatal TSH level of the entire blood spot was categorized as > 20 mIU/L and < 20 mIU/L and the blood spot TSH > 20 mIU/L was considered as positive for congenital hypothyroidism. Among the newborns, 18% (n=86) of them were identified as positive with 10 % males and 8% females. Only one newborn was diagnosed as being congenitally hypothyroid (serum TSH >9.8 mIU/L and free T4< 10 pmol/L) with very high blood spot TSH value of 360.91 mIU/L. Further, a higher prevalence (37.7%) of neonates with blood spot TSH >5 mIU/Lwas observed in this study.
International Journal of Paediatrics and Geriatrics, 2020
To evaluate the incidence of congenital hypothyroidism using cord blood thyroid stimulating hormone (CB-TSH) levels and examining the influence of maternal and perinatal factors on these levels in our cohort of babies. Design: A cross-sectional study. Setting: Tertiary care teaching hospital, China Kakani, A.P. Methods: CB-TSH levels were measured in 2012 live-born neonates using electro chemiluminescence immunoassay. The effect of various maternal and perinatal factors on CB-TSH levels was analyzed statistically by multivariate analysis. Results: The mean CB-TSH was 8.86 micro IU/ml (ranged between 0.23 to 100micro IU/ml). The incidence of high CB-TSH (>20microIU/ml) was 4.82%. CB-TSH levels were significantly raised in neonates delivered in 1 st and 2 nd birth order, assisted vaginal deliveries, need for emergency section, and who were born with low APGAR scores (p<0.01 and Cron-bach's alfa 0.932). Maternal hypothyroidism or maternal hypertension, weight appropriateness for gestation, birth weight and gestational age had no significance. Conclusion: Upon multivariate analysis, the need for resuscitation, mode of delivery, and birth order were found to be significant factors affecting CB-TSH levels. Hence, these factors must be considered cautiously while interpreting CB-TSH values.
Umbilical cord blood TSH levels in term neonates: a screening tool for congenital hypothyroidism
Indian pediatrics, 2005
This study was conducted to find normative values for thyroid stimulating hormone (TSH) in 1200 cord blood samples of term babies whose mothers were not on any thyroid medications. TSH was estimated within 24 hrs by enzyme immunoassay. A full thyroid profile, viz, T3, T4, TSH, fT3 and fT4 was done at 7-10 days of age in all babies with cord TSH >20 mIU/L. The mean, median and standard deviation for the TSH values for the cohort were 6.13 mIU/L, 5.8 mIU/L and 4.523 respectively. 22 babies with TSH values >20 mIU/L were given repeat tests. Hypothyroidism was confirmed in two of these babies. We conclude that a cut off value of TSH >20 mIU/L is adequate for neonatal thyroid screening in Indian settings.
IOSR Journals , 2019
INTRODUCTION: Congenital hypothyroidism is the most common preventable cause of mental retardation. Features of congenital hypothyroidism are nonspecific and difficult to identify in the neonatal period. They become prominent with increasing age. However the window period for neurological intervention has elapsed in most patients by this time. The female to male ratio is 2:1. If congenital hypothyroidism is diagnosed promptly and treated early irreversible mental retardation can be prevented. AIMS AND OBJECTIVES:The aim of neonatal screening program is to detect affected neonates and provide replacement to them as early as possible so that severe physical and mental handicap can be prevented by early treatment.To evaluate the effectiveness of cord blood TSH screening to detect cases with hypothyroidism. METHODS: A cross sectional study conducted on babies born in department of obstetrics and gynaecology,RIMS Ranchi. Umbilical cord blood sample was collected in a sterile container drawn from the umbilical cord incised at the time of birth. TSH level was estimated within 24 hours by chemiluminescent microparticle immunoassay (CMIA) method in department of laboratory medicine/biochemistry RIMS,Ranchi. RESULT: Number of confirmed case of congenital hypothyroidism was 1/200. There were total 7 cord blood samples whose TSH values ≥20mIU/L but a repeat test on 2-4 days of life confirmed CH in one of these samples. Mean TSH value female was 7.27± 0.89mIU/Lwhile mean TSH value for male was 6.89±0. These studies need larger sample size and stronger logistic effort with team approach.7.5% of newborns in our series had values between 10.1-19.9mIU/L.This is the group which needs further evaluation to confirm thyroxine deficiency either acquired or congenital. CONCLUSION: Due to the practice of early discharge in our country cord blood estimation remains a very practical method for screening purpose.Use of cord blood TSH as a screening tool is an attractive method because of its simplicity and accessibility.The Indian Academy of Pediatrics recommends the use of cord blood samples for screening for congenital hypothyroidism.
Frequency of Neonatal Thyroid Disorders in a Tertiary Care Hospital in Karachi
2019
Background: Thyroid hormone is necessary for metabolism, growth and brain development. Thyroid-stimulating hormone (TSH) secreted by anterior pituitary gland acts on thyroid to release thyroid hormones T3 and T4. Insufficient production of thyroid hormone at birth is known as congenital hypothyroidism (CH). CH leads to intellectual impairment, if not identified. Neonatal hyperthyroidism is relatively uncommon The objective of this study is to determine the frequency of thyroid disorders in neonates born in a tertiary care hospital. Methods: This is retrospective cross-sectional, observational study carried out at the tertiary care hospital Karachi, from October 2017 to May 2018. Screening for thyroid disorders is mandatory for newborns born in our hospital. Only data of neonates with thyroid stimulating hormone (TSH) performed was included for this study. TSH levels of these patients were determined by immunoassay on Vitros Enhanced Chemiluminescence technique. Results: In this stud...
Normative Data of Thyroid Gland Volume in South Indian Neonates and Infants
Indian journal of pediatrics, 2018
To establish normative ultrasound data for thyroid gland volume in South Indian neonates and infants and compare with abnormal sonological features of thyroid in congenital hypothyroidism (CH) to explore thyroid ultrasound utility as a supportive screening tool to newborn screening programs for early detection of CH. In view of impact of geo ethnic factors, varying growth velocities and body mass indices of human population worldwide, specific regional, age and gender related reference data for thyroid gland size and volume are vital. This study was an offshoot of ICMR pilot New Born Screening (NBS) project for CH. Formula used for thyroid volume estimation was ellipsoidal formula D1 x D2 x D3 × 0.523. It was a prospective observational study. The neonates who screened negative for Thyroid Stimulating Hormone (TSH) with repeat normal serum TSH and free thyroxine were selected. One hundred fifty seven infants were enrolled which included 99 boys and 58 girls. The study population inc...
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Congenital Hypothyroidism (CH) is one of the most common disorders related to mental impairment and growth retardation in newborns. The main objective of screening is to detect and treat them early so as to prevent or minimize the neuropsychological damage which can be irreversible if the treatment is delayed beyond the first few weeks of life. In our institution, we do concomitant T4 and TSH after 48 hours of birth for screening. This study is aimed at assessing the usefulness of cord blood thyroid stimulating hormone (CBTSH) screening compared to TSH on 3 rd postnatal day. METHODS A retrospective study was done in 272 term neonates at birth to analyse the cord blood TSH levels and TSH levels were tested for on 3rd postnatal day. The values were statistically analysed using Fisher's exact test. RESULTS 272 babies were enrolled in the study. 17 (6.25%) babies had cord blood TSH above 20 mIU/ml and 11 (4.04%) babies had TSH values more than 10 mIU/ml in the 3 rd day sample. The mean value of CBTSH was 9.68 microU/ml (SD +/-8.47) and that of 3 rd day TSH was 3.76 microU/ml (SD +/-3.17). 4 out of the 11 babies with elevated TSH levels on 3 rd day was found to have congenital hypothyroidism on further follow up. CONCLUSIONS This study reveals a high proportion of congenital hypothyroidism when compared to national and international references, thus highlighting the need for universal screening. According to our study, cord blood TSH cannot substitute the 3 rd day TSH for diagnosing congenital hypothyroidism.
Screening of New-Borns for Thyroid Status Admitted in Neonatal Ward of a Tertiary Care Hospital
Chattagram Maa-O-Shishu Hospital Medical College Journal, 2022
Background: Neonatal screening program is very fruitful in saving our newborns from preventable neonatal diseases, thereby healthy grooming of future generations. Though newborn screening for a thyroid disorder is one of the greatest successes in preventive pediatrics but still has not practically worked out for all neonates in Bangladesh at the national level.The majority of newborns with a thyroid disorder have a normal appearance without detectable physical signs and are almost always missed. Screening at the proper time (Approximately 2-7 days after birth), rechecking of suspicious cases within a week, and initiation of treatment (Within 2 weeks of age) of thyroid disorders particularly Congenital Hypothyroidism (CH), can prevent the irreversible mental and physical impairments. Transient neonatal hyperthyroidism is the common form of neonatal hyperthyroidism. The purpose of the study was, Neonatal Screening (NS) to evaluate the rate of thyroid disorders among Preterm (Early preterm born before 34 th week of gestation, late preterm born between 34 th week and before 37 th week of gestation), Term (Born within 37 th to 42 nd week of gestation) and Post-term (Born after 42 nd week of gestation) newborns. Birth weight was alsomeasured to categorize the newborns according to their weight.
The relation between serum and filter paper TSH level in neonates with congenital hypothyroidism
Advanced biomedical research, 2014
the aim of this study was to determine the relation between serum and filter paper thyroid-stimulating hormone (TSH) levels in neonates with congenital hypothyroidism (CH). We also tried to determine an appropriate cutoff point of filter TSH for recalling screened neonates. in this descriptive-analytic study, records of 2283 neonates who had been recalled during CH screening program in Isfahan (Iran) were studied. The relation between serum and filter paper TSH levels in the studied neonates was assessed and the best cutoff point of filter TSH and its sensitivity and specificity for proper diagnosis of CH were determined. among the studied neonates, 103 (4.5%) were diagnosed with CH. Using receiver operating characteristic (ROC) curve, the best cutoff point for diagnosing CH was 7.5 with a sensitivity of 74.8% and specificity of 71.3%. The rates of false positive and false negative diagnoses at this cutoff point were28.7% and 25.2%, respectively. There was a significant relationship...
Thyroid Stimulating Hormone values from cord blood in neonates
Ethiopian Journal of Health Development, 2004
Objectives: To determine thyroid stimulating hormone (TSH) levels from cord blood in neonates and to establish the practice for possible application of congenital hypothyroidism screening in Ethiopia. Methods: TSH was measured from cord blood of 1207 consecutive new-borns in the maternal wards of St. Paul, Ghandi Memorial and Tikur Anbesa hospitals in Addis Ababa, Ethiopia. TSH Immunoradiometric assay (IRMA) was used with anti-TSH coated beads and I 125 labelled TSH monoclonal antibodies. Results: Males (89.5%) and females (91.8%) had non detectable and/or less than 10 mIU/l TSH values. From the total of 548 male and 659 female neonates 10.2% males and 8% females had TSH values between 10-20 mIU/l. Only three neonates had raised TSH values, which was greater than 20 mIU/l. Conclusions: Cord blood is practical and apparently simple to collect. It is applicable for blood spot analysis of congenital defects. It can be put in practice for large scale screening programmes such as congenital hypothyroidism (CH) in the Ethiopia situation where hospital discharges are within 24 hrs of delivery given all the necessary infrastructures in place.