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Updated: Jul 31, 2026
Biochemical Measurement of Neonatal Hypoxia
Published on: August 24, 2011
Screening for congenital hypothyroidism (CH) among Filipino newborn infants. Philippine Newborn Screening Study Group
C Fagela-Domingo1, C D Padilla, E M Cutiongco
1College of Medicine and Philippine General Hospital, University of the Philippines, Manila.
Insights
This study screened 62,841 newborns for congenital hypothyroidism (CH) using thyroid stimulating hormone (TSH) assays. The incidence was 1:3,610, potentially higher than global averages, with a 0.16% recall rate.
Area of Science:
- Neonatal screening
- Endocrinology
- Public health
Background:
- Congenital hypothyroidism (CH) is a common endocrine disorder in newborns.
- Early detection and treatment are crucial to prevent developmental delays.
- Newborn screening programs aim to identify CH cases effectively.
Purpose of the Study:
- To determine the incidence of congenital hypothyroidism in a specific newborn population.
- To evaluate the effectiveness of the thyroid stimulating hormone (TSH) assay screening method.
- To analyze the recall rate and identify factors influencing it.
Main Methods:
- Screening of 62,841 newborns between June 1996 and June 1998.
- Primary testing using an immunofluorescent assay (DELFIA TSH Kit) on dried blood spots.
- Confirmatory testing via radioimmunoassay for infants with elevated TSH levels (>20 microU/ml).
Main Results:
- The overall weighted incidence of CH was 0.000277 (1:3,610), potentially higher than reported globally.
- A recall rate of 0.16% was observed.
- Factors such as early testing and potential maternal iodine deficiency may have contributed to the recall rate.
Conclusions:
- The study suggests a potentially higher incidence of CH, warranting further investigation with larger infant cohorts.
- Recommendations include establishing age-specific normal TSH values to optimize screening protocols and reduce recall rates.
- Continued monitoring and refinement of screening methods are essential for effective CH management.
Abstract:
From June 1996 to June 1998 a total of 62.841 newborn infants were screened for congenital hypothyroidism with thyroid stimulating hormone assay as a primary test. The method used was an immunofluorescent assay using the DELFIA TSH Kit on dried blood specimens collected by heelprick on filter paper. All infants with TSH values greater than 20 microU/ml were retested. If the results remained abnormally high, confirmatory testing was done by radioimmunoassay. All infants who were confirmed to be hypothyroid were referred to pediatric endocrinologists for initial management. The overall weighted incidence of congenital hypothyroidism obtained in this study was 0.000277 (95% CI; 0.000122 - 0.000432) or 1:3,610 which may be higher than that reported by most screening programs worldwide. The recall rate was 0.16%. The higher recall rate may be explained by early testing in a number of cases and by the possibility of iodine deficiency in some of the mothers. On the basis of the results of this study, we would recommend (1) screening on a greater number of infants to verify the incidence of CH and (2) establishing normal TSH values at different hours of life to improve our recall rate.
