Unfolding the perinatal factors that affect cord blood thyroid stimulating hormone levels- an experience from a rural centre in southern India (original) (raw)
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Effect of perinatal factors on cord blood thyroid stimulating hormone levels
International Journal of Contemporary Pediatrics
Background: Screening for congenital hypothyroidism (CH) is a routine practice in most developed countries of the world. This can be done by measuring cord blood thyroid stimulating hormone (CBTSH). Apart from foetal thyroid status and iodine nutrition status of the population, many perinatal factors may also affect CBTSH. The influence of these perinatal factors may affect the sensitivity of CBTSH as a screening tool for CH. The present study was carried out to study the influence of various perinatal factors on CBTSH level. Methods: It was a cross sectional study conducted in tertiary care centre in North Maharashtra. 793 new-borns were included in study. Effects of perinatal factors like maternal age, parity, gender of the baby, birth weight, mode of delivery, gestational age, birth asphyxia on CBTSH was analysed with appropriate scientific method. Results: The mean TSH level in the study group was 7.56±3.9 mIU/l. Among the associated factors vaginal delivery, low gestational age...
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.
Effect of maternal and neonatal factors on cord blood thyroid stimulating hormone
Indian Journal of Endocrinology and Metabolism, 2016
Background: Congenital hypothyroidism (CH) is most common preventable cause of mental retardation in children. Cord blood Thyroid Stimulating Hormone (CBTSH) level is an accepted screening tool for CH. Objectives: To study CBTSH profile in neonates born at tertiary care referral center and to analyze the influence of maternal and neonatal factors on their levels. Design: Cross retrospective sectional study. Methods: Study population included 979 neonates (males = 506 to females = 473). The CBTSH levels were estimated using electrochemiluminescence immunoassay on Cobas analyzer. Kit based cut-offs of TSH level were used for analysis. All neonates with abnormal CBSTH levels, were started on levothyroxine supplementation 10 μg/Kg/day and TSH levels were reassessed as per departmental protocol. Results: The mean CBTSH was 7.82 μIU/mL (Range 0.112 to 81.4, SD = 5.48). The mean CBTSH level was significantly higher in first order neonates, neonates delivered by assisted vaginal delivery an...
Cord Blood TSH Level Variations in Newborn – Experience from A Rural Centre in Southern India
Journal of Clinical and Diagnostic Research, 2014
Background: Universal screening of all neonates has for long been recognized as the most effective method to detect congenital hypothyroidism. However, various maternal as well as perinatal factors can influence the cord blood TSH levels. Objectives: To evaluate the effect of perinatal factors on cord blood TSH level variations in neonates born in a rural tertiary care institution in South India.
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.
Indian Journal of Medical Biochemistry, 2022
Aim: To find the normative value of cord thyroid-stimulating hormone (TSH) in neonates in our study group for screening congenital hypothyroidism (CH). Objectives: 1. To establish the cutoff level of cord TSH in full-term and preterm neonates. 2. Correlate cord TSH value with birth weight, gender, and gestational age. Materials and methods: A prospective study was conducted in tertiary care hospital for a period of 1 year from 1st February 2019 to 31st January 2020. Umbilical cord blood (3 mL) collected in sterile vacutainer under aseptic precaution, at the time of delivery from the maternal end of cord and TSH was estimated by chemiluminescent microparticle immunoassay (CMIA) technique. This study was carried out on 1,357 neonates. All data were collected prospectively. Mothers with thyroid illness and/or thyroid medication were excluded from the study. Results: Umbilical cord TSH sample was tested on all 1,357 babies delivered in tertiary hospitals for a period of 1 year. Seven hundred and fifty were males (55.2%) and 607 were females (44.7%). One thousand and sixteen were normal term (74.8%) babies. The mean, median, and standard deviation of cord TSH values were 6.8, 5.5, and 4.5, respectively, in term neonates. Thyroid-stimulating hormone value corresponding to 90th, 95th, and 97th percentile was 16.5, 18.9, and 24.8 percentile in term neonates. Cord TSH values of >20 mIU/L were found in 30 (2.2%) neonates. One neonate had persistently higher TSH on repeat testing. There was no significant correlation of cord TSH between birth weight and gender of neonates but we found a significant correlation of gestational age with cord TSH value (p value < 0.05). Conclusion: Incidence of CH was 1 in 1,357 in our study. Umbilical cord TSH is a significant investigation for screening CH and a cutoff of >20 mIU/L can be used for screening CH.
Objective: To study the serum levels of Thyroid Stimulating Hormone (TSH) in neonates. Also to assess the sex differences in thyroid function and to compare our results to previously published reference data. TSH was estimated in 91 neonates using enhanced Chemiluminescence technique using vitros ECi-Ortho Clinical Diagnostics. Results: Although the mean serum levels of TSH were higher in females, no significant differences were observed in serum TSH between males and females. Conclusion: The study underlines the importance of new born screening for thyroid dysfunction. Due to high reported prevalence of congenital Hypothyroidism (CH) in our country and the lack of international standardization, performing multi-central studies with more population helps in making a more precise evaluation of thyroid status in neonates. Frequent laboratory monitoring in infancy is essential to ensure optimal neurocognitive outcome. Serum TSH and free T4 should be measured every 1- 2 months in the first 6 months of life and every 3-4 months thereafter. In general, the prognosis of infants detected by screening and started on treatment early is excellent. Keywords: Thyroid stimulating hormone (TSH), congenital hypothyroidism (CH), chemiluminescence
Perinatal variables influencing cord blood thyroid stimulating hormone
International Journal of Contemporary Pediatrics, 2018
Most newborns with congenital hypothyroidism appear normal at birth, making clinical diagnosis difficult. Newborn screening aids in early diagnosis and timely treatment to prevent disability. Most of the developed countries have a well-structured newborn screening program for congenital hypothyroidism but it is still lacking in India. Newborn screening method measures Thyroid Stimulating Hormone (TSH) either in cord blood sample or a heel prick sample on day 3 or 4 of life. Cord blood TSH has high sensitivity with a high false positive rate. It also has the advantages of being easy to