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Initial versus confirmatory thyroid stimulating hormone (TSH) levels: is there a correlation?
Sylvia Capistrano-Estrada1, Kahlil Izza T dela Cruz, Carmencita Padilla
1Institute of Human Genetics, National Institutes of Health, University of the Philippines Manila.
Summary
Newborn screening in the Philippines identified congenital hypothyroidism (CH) in 51 infants over five years. Early TSH screening is effective, but timely follow-up remains crucial for CH management.
Area of Science:
- Endocrinology
- Pediatrics
- Public Health
Background:
- Congenital hypothyroidism (CH) is a treatable endocrine disorder in newborns.
- Early detection through newborn screening is vital to prevent developmental delays.
- The Philippines implemented newborn screening for CH in 1996.
Purpose of the Study:
- To evaluate the effectiveness of the newborn screening program for CH in the Philippines.
- To analyze the incidence, confirmation rates, and follow-up of CH cases.
- To assess factors influencing TSH levels and the association with gender.
Main Methods:
- Analysis of data from 176,548 screened newborns between June 1996 and September 2001.
- Utilized fluoroimmunometric assay for thyroid-stimulating hormone (TSH) on dried blood spots.
- Statistical analysis including correlation, Kruskal-Wallis, and Fisher's exact tests.
Main Results:
- 51 out of 176,548 newborns (0.029%) were confirmed with CH.
- Initial TSH levels showed a significant correlation with confirmatory TSH levels (p=0.0002).
- No significant difference in TSH levels based on sample collection time or gender was found.
Conclusions:
- The Philippine newborn screening program effectively identifies CH.
- Levothyroxine treatment was initiated at a mean age of 1.5 months.
- Improved follow-up strategies are needed to reduce loss to follow-up after CH confirmation.