Congenital hypothyroidism screening program in iran; a systematic review and metaanalysis

Area of Science:

• Neonatal screening
• Endocrinology
• Public health

Background:

• Congenital hypothyroidism (CH) can cause intellectual disability if not treated promptly.
• Early detection through newborn screening and timely thyroid hormone replacement is crucial for normal cognitive development.

Purpose of the Study:

• To systematically review and evaluate the national CH screening program results across Iranian provinces.
• To assess the incidence and recall rates of CH in Iran.

Main Methods:

• A systematic literature review of national and international databases (PubMed, Scopus, Web of Science, etc.).
• Meta-analysis of 25 studies involving 1,425,124 neonates using random-effects models.
• Exploration of heterogeneity using meta-regression.

Main Results:

• The pooled recall rate for TSH ≥5mIU/L was 0.014 (95% CI: 0.013-0.015).
• The overall incidence of CH was determined to be 2 per 1000 neonates (95% CI: 0.002-0.002).
• No significant increase in CH incidence over time was observed (P=0.08).

Conclusions:

• The current TSH cut-off of ≥5mIU/L for recalling neonates has a low positive predictive value (14%).
• Further research is required to establish more accurate TSH thresholds for neonatal recall.
• Optimizing screening criteria can improve the efficiency and accuracy of CH detection programs.