scholarly journals Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases

2000 ◽  
Vol 118 (5) ◽  
pp. 144-147 ◽  
Author(s):  
Laura Sterian Ward ◽  
Ilda Shizue Kunii ◽  
Rui Monteiro de Barros Maciel

CONTEXT: Screening programs not only offer the opportunity to trace and treat almost all cases of congenital hypothyroidism but also mean large savings to the health system. However, carefully planned strategies are necessary to extend their benefits and reduce costs. OBJECTIVE: To determine the possible influence of maternal diseases that affect maternal-fetal placenta dynamics on primary thyroid stimulating hormone (TSH) screening for congenital hypothyroidism. DESIGN: Prospective non-randomized clinical trial with at least 3 months of follow-up. SETTING: A public university referral center [CAISM/Hospital das Clínicas, Faculty of Medicine, University of Campinas, Campinas, SP]. PARTICIPANTS: 415 neonates divided into 5 groups: eighty-three infants born from cardiac mothers; 98 from mothers that had toxemia; 54 of the mothers had diabetes mellitus; 40 were HIV positive and 140 had no diseases. INTERVENTION: All newborns had cord blood samples collected on filter paper at birth. MAIN MEASUREMENTS: TSH was measured from dried blood spots using a homemade immunofluorescence assay (sensitivity in dried blood spots = 0.1 mU/L). RESULTS: There was no significant difference in the mean TSH levels among the 5 groups. Moreover, TSH levels were around 5 mU/L in 48% of the newborns, indicating that our region is severely deficient in iodine. CONCLUSIONS: Our results indicate that primary TSH screening programs using cord blood are not affected by maternal diseases. We suggest that, besides its technical advantages over heel punctures with T4 primary approaches, neonatal screening using primary cord blood TSH may also be used as a monitoring tool for evaluation and control of iodine deficiency disorders (IDD).

2020 ◽  
Vol 7 (2) ◽  
pp. 397
Author(s):  
Gaddam Eluzai Zion ◽  
Raheemunnisa .

Background: Congenital hypothyroidism (CH) is one of the common preventable cause of intellectual disability. Most cases of CH result from thyroid dysgenesis. CH is often asymptomatic in early infancy, and any delay in treatment can affect the child in terms of delayed cognitive milestones. NSCH (newborn screening for congenital hypothyroidism) has been universally accepted and it is one of the most cost effective screening programs in the field of preventive medicine and public health.Methods: A cross sectional study was conducted in Sri Venkata Sai Medical College and Hospital from 28th August to 28th February 2019 (1.5 years), this study was done on 73 newborns (70 deliveries, three mothers gave birth to twins). All data was collected prospectively. Mothers with known thyroid disease or on thyroid medication were excluded from the study. Under sterile aseptic conditions blood sample is collected from the umbilical cord soon after delivery.Results: In the present study Cord blood TSH level of >20 mIU/L was present in 10% (7) of neonates. When the blood TSH levels were repeated (on day 3) among those with high cord blood TSH levels (>20), the blood TSH levels was also high (>20) in 6 (85.7%) neonates and low (<20) in 1 (14.2%). In Neonates with cord blood TSH >20, 6 neonates also had Low T4 (T4<7) levels (85.7%) and 1 neonate (14.2%) had T4 >7. In the present study 6 neonates (85.7%) had Congenital Hypothyroidism. The present study finds that Cord blood TSH as a diagnostic tool has Sensitivity of 100% and specificity of 98.5% in diagnosing congenital hypothyroidism.Conclusions: The current study concludes that Cord blood TSH is a sensitive and specific marker to predict the presence of congenital hypothyroidism in neonates.


2021 ◽  
Vol 7 (1) ◽  
pp. 8
Author(s):  
Rebecca McMahon ◽  
Lenore DeMartino ◽  
Mycroft Sowizral ◽  
Diana Powers ◽  
Melissa Tracy ◽  
...  

Newborn screening for congenital hypothyroidism (CH) is performed by measuring the concentration of thyroxine (T4) and/or thyroid-stimulating hormone (TSH) in dried blood spots. Unfortunately, the levels of T4 and TSH vary due to multiple factors, and therefore the false-positive rate for the test is a challenge. We analyzed screening data from 2008 to 2017 to determine the effect of seasonal changes and manufacturer kit lot changes on T4 and TSH values and on numbers of infants referred. Over a 10-year period, we screened 2.4 million infants using commercially available fluoroimmunoassays to measure T4 and TSH concentrations in dried blood spots. During colder months, daily mean T4 and TSH values were higher and referral rates and false-positive rates were higher. However, there was no significant difference between the number of confirmed CH cases. Furthermore, in rare instances, we observed differences in T4 daily mean values during the 10-year period when manufacturer kit lot changes were made. Seasonal temperature variations influence measured T4 and TSH values and consequently lower the positive predictive value for CH testing in colder months. Newborn screening (NBS) programs should be aware that manufacturer kit lot changes may also influence T4 values.


2018 ◽  
Vol 5 (4) ◽  
pp. 1537 ◽  
Author(s):  
Manasi D. Garg ◽  
Poornima Kumar ◽  
Sakthi Abirami ◽  
Manikandan M. ◽  
Lalitha Krishnan

Background: Newborn screening using cord blood Thyroid Stimulating Hormone (TSH) is an effective and an easy way to screen babies for congenital hypothyroidism. Congenital hypothyroidism is a common preventable and treatable cause of mental retardation. Early diagnosis with the help of newborn screening aids in timely management and decreased morbidity. Various maternal and neonatal variables can affect cord blood TSH level thereby affecting the accurate diagnosis of congenital hypothyroidism. This study aims at studying the perinatal variables affecting cord blood TSH.Methods: In a retrospective cross-sectional study conducted in a tertiary care hospital, the hospital case records of 1465 newborn and their mother were studied for variables including cord blood TSH, maternal age, mode of delivery, parity, gender of baby, gestational age and growth of baby. The effect of these perinatal variables on cord blood TSH was analysed statistically. P value below 0.05 was considered as statistically significant. The statistical analysis was done used the SPSS software version 18.0.Results: The median cord blood TSH was 8 microIU/ml (IQR= 6-12) with 8.1% newborns having values more than 20 microIU/ml. Cord blood TSH was significantly raised in male babies (p <0.01) and in neonates born by assisted vaginal delivery (p <0.01).  Significant increase in cord blood TSH (p <0.02) was observed in neonates born to primiparous mothers. Maternal age, gestational age of the newborn and growth of the newborn did not have significant effect on cord blood TSH values.Conclusions: The mode of delivery, parity and gender of the baby were found to be significant variables affecting cord blood TSH values. Hence, cord blood TSH values should be interpreted in the light of these perinatal variables.


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