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Published on: March 17, 2023
[Reference intervals for serum thyrotropin during the first 14 days of life]
1Hospital Privado de Córdoba, Argentina. lucyanis@hotmail.com
Insights
Early detection of congenital hypothyroidism (CH) is crucial. This study found that serum thyroid-stimulating hormone (TSH) levels decrease with age in newborns up to 14 days, establishing new reference intervals for better diagnosis.
Area of Science:
- Neonatal screening
- Endocrinology
- Pediatric diagnostics
Context:
- Congenital hypothyroidism (CH) screening is vital for preventing developmental issues.
- Accurate reference intervals for serum thyroid-stimulating hormone (TSH) are needed to improve screening specificity.
- Existing screening protocols require refinement for optimal early detection.
Purpose:
- To establish reference intervals for serum TSH in newborns aged 2 to 14 days.
- To investigate the relationship between TSH levels and infant age within the first two weeks of life.
- To enhance the diagnostic accuracy of neonatal screening for CH.
Summary:
- A study of 6772 newborns (2001-2007) analyzed serum TSH levels using electrochemiluminescence.
- A statistically significant inverse relationship was observed between TSH levels and infant age, with TSH decreasing from day 2 to day 14.
- Mean TSH was 4.42 µU/ml (± 4.17), showing a decline from 5.82 µU/ml at day 2 to 2.58 µU/ml at day 14.
Impact:
- The established TSH reference intervals aid in more precise thyroid status assessment in neonates.
- Improved diagnostic capabilities can lead to timely and appropriate individual therapeutic interventions for CH.
- This research contributes to refining neonatal screening programs for congenital hypothyroidism.
Introduction:
Early detection of congenital hypothyroidism (CH) prevents impaired cognitive and motor development at problems. To increase the screening program specificity, we defined reference intervals for serum TSH in newborns between 2 and 14 days of life.
Patients And Methods:
Newborn infants from our neonatal screening program between 2001 and 2007. Serum TSH was determined by electrochemiluminescence. There were excluded neonates who died before the first month of life or with less than 1500 grams at birth, samples with TSH <0,01 µU/ml., processed after 14 days of life and from other medical centers. Statistical tools: Student t-tests, measures of centrality and dispersion, and logarithmic transformations.
Results:
Studied population: 6772 newborn infants out of 7869, 50.49% were males. The male/ female ratio was similar during the 14 days. The mean age at testing was 5.85 days (± 2.58), and the mean of TSH value was 4.42 µU/ml (± 4.17). Inverse relationship was found between age and TSH (mean TSH at days 2 and 14 was 5.82 µU/ ml and 2.58 respectively).
Conclusion:
We found statistical evidence on an inverse relationship between TSH and age in newborn infants with 14 days of age. Reference intervals for TSH contribute to a better assessment of thyroid status in neonates and to define an appropriate conduct for individual therapy.
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