Results of congenital hypothyroidism screening program in the area under coverage of Shahid Beheshti University of Medical sciences in 1390

24th International Congress on Pediatrics & 10th Congress on Pediatrics Nursing

11 till 15 October 2012، Tehran - Iran

Presentation Type: Speech
Abstract:

Neonatal screening programs (NSP) examined more than 150 million newborns untill 1999, and about 42000 Congenital Hypothyroidism (CH) patients were diagnosed. Nowadays, almost all developed countries implement NSP for CH. Developing countries also implement these programs gradually. CH incidence is 1 in 3500-5000, 1 in 3000, 1 in 6600-7300 and 1 in 5700 live births in U.S., Europe, Sweden and Japan, respectively. Methods: All pregnant women or newly mothers living in the area under coverage of Shahid Beheshti Medical University were advised to take their 3-5 day's old newbornes to CH screening centers. A blood sample was taken from lateral parts of the newborn heel, using a Lancet and Guthrie paper. Thyroid Stimulating Hormone (TSH) level 5 to 9.9 mu/l led to repeated heel blood sample exam. If TSH level in first sample was ≥ 10 mu/l, or in repeated sample was ≥ 5 mu/l, a venous blood sample was taken for laboratory testing. Patients who had a venous TSH level ≥ 10 mu/l were considered as CH and were referred to a specialist for treatment. Treatment was begun urgently before referring, if venous TSH was ≥ 20 mu/l. Findings: Totally 123329 newborns were screened during one year. Heel blood sample TSH in 4385 (3.5%) and in 685 (0.5%) cases was 5-9.9 and ≥ 10 mu/l, respectively. 310 CH patients (158 boys and 152 girls) were diagnosed. The incidence rate was 1 in 398 screened newborns. Various towns reported differe nt incidence rates ranging from 1 in 829 in eastern parts of Tehran (half of the university average) to 1 in 108 in Firoozkouh (about 4 times higher than university average). 134 patients (43.2%) were offspring of a Cesarian Section delivery and 27 cases (8.7%) were Low Birth Weight (LBW). Conclusion: The University overall incidence rate was similar to that of the whole country. There may be an association between incidence rate and mothers' nutrition, Iodine level in the area, delivery type and so on and further investigations and interventional programs are needed.