Unfolding the perinatal factors that affect cord blood thyroid stimulating hormone levels- an experience from a rural centre in southern India (original) (raw)

International Journal of Paediatrics and Geriatrics

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.