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[Screening for congenital hypothyroidism in 106 224 neonates in Hunan Province]
Xi-yan Wu1, Hua Wang, Ding-mei Huang
1Maternity and Child Health Care Hospital of Hunan Province, Changsha 410008, China. wxy525@163.com
Insights
Early diagnosis of congenital hypothyroidism (CH) through neonatal screening is crucial for preventing intellectual disability. This study highlights a higher CH incidence in Hunan province, emphasizing the need for effective screening protocols.
Area of Science:
- Endocrinology
- Neonatal screening
- Public health
Context:
- Congenital hypothyroidism (CH) is a treatable condition that can cause irreversible intellectual disability if not diagnosed and managed promptly after birth.
- Neonatal screening programs are essential for early detection of CH.
- The study focuses on CH screening in Hunan province, China.
Purpose:
- To evaluate the effectiveness of neonatal screening for congenital hypothyroidism.
- To determine the incidence of CH in Hunan province.
- To establish optimal screening parameters for early CH diagnosis.
Summary:
- A neonatal screening program measured thyroid-stimulating hormone (TSH) using time-distinguished fluorometry immunoassay.
- Positive TSH results were confirmed with serum TSH, free triiodothyronine (FT3), and free thyroxine (FT4) measurements via chemiluminescence immunoassay (CLIA).
- Out of 106,224 neonates screened in Hunan province, 68 cases of CH were confirmed, yielding a positive rate of 1/1,562, significantly higher than the national average.
Impact:
- Neonatal screening is vital for early CH diagnosis and prevention of mental retardation.
- Hunan province exhibits a higher prevalence of CH.
- Optimizing screening criteria and critical values is essential to minimize missed cases and improve diagnostic accuracy.
Objective:
Diagnosing congenital hypothyroidism (CH) early was studied in this paper through neonatal screening to prevent children's mental retardation.
Methods:
The first step is mensurating the concentration of thyroid stimulating hormone (TSH) with the method of time-distinguished fluorometry immunoassay. If the result is positive, then it is necessary to mensurate the serum TSH, free triiodothyronine (FT3),free thyroxin (FT4) with chemiluminescence immunoassay (CLIA) and execute clinical diagnosis.
Results:
There were 68 confirmed congenital hypothyroidism patients among the 106,224 samples from Apr.1997 to Dec.2003 in Hunan province. The positive rate was 1/1,562, which was obviously higher than the national average value (1/3,009).
Conclusion:
First, neonatal screening is the key to prevent mental retardation through early diagnosing and treating CH. Second, the probability of suffering CH is high in Hunan province. Third, the positive rate is relative to the development of science and technology, while the accumulated rate is better to reflect the real incidence of the disease. Fourth, selecting proper critical value will help to prevent missing screening.