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Congenital hypothyroid screening using cord blood TSH
1Department of Paediatrics, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Singapore Medical Journal
|June 11, 1999
Summary
This pilot study estimated the incidence of congenital hypothyroidism (CH) in Kuala Lumpur, Malaysia, at one in 3,666 live births. Public education is crucial for the success of neonatal screening programs.
Area of Science:
- Neonatal screening
- Endocrinology
- Public health
Background:
- Clinical diagnosis of congenital hypothyroidism (CH) is challenging at birth without screening.
- Preventive medicine is a priority in Malaysia, emphasizing early CH diagnosis and treatment.
- A pilot study was conducted in Kuala Lumpur to estimate CH incidence and assess neonatal screening challenges.
Purpose of the Study:
- To estimate the incidence of congenital hypothyroidism (CH) in Kuala Lumpur.
- To evaluate the challenges of large-scale neonatal screening for CH.
- To assess the utility of a commercial TSH kit for cord bloodspot screening.
Main Methods:
- Screened 11,000 newborns using cord blood spots.
- Utilized a commercial TSH kit for initial screening.
- Recalled newborns with elevated cord TSH levels for re-evaluation.
Main Results:
- An estimated incidence of CH was one in 3,666 live births.
- 2.27% of newborns had cord TSH > 20 mIU/L, requiring recall.
- Three cases of CH and one of transient hyperthyrotropinemia were confirmed.
Conclusions:
- High dropout rates (26% untraceable, 48% non-responsive to recall) impacted the study.
- Public education and awareness are vital for the cost-effectiveness of screening programs.
- Early detection and treatment of CH are critical for infant health.