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Updated: Jun 2, 2025
Biochemical Measurement of Neonatal Hypoxia
Published on: August 24, 2011
Newborn screening for congenital hypothyroidism: worldwide coverage 50 years after its start
Marta Arrigoni1,2, Nitash Zwaveling-Soonawala1,3, Stephen H LaFranchi4
1Department of Pediatric Endocrinology, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam and Vrije Universiteit, European Reference Network on Rare Endocrine Conditions (Endo-ERN) Amsterdam, The Netherlands.
Insights
Newborn screening for congenital hypothyroidism (CH) has expanded, but 70% of infants globally still lack access, particularly in Africa and Asia. Global iodine sufficiency has improved, yet widespread CH screening remains a challenge.
Area of Science:
- Public Health
- Pediatrics
- Endocrinology
Background:
- Congenital hypothyroidism (CH) is a leading preventable cause of neurodevelopmental delay in children.
- Newborn screening (NBS) programs for CH are crucial public health strategies, established in many countries since 1974.
- Despite progress, global NBS coverage for CH remained low in 2014, screening only 29.3% of newborns.
Purpose of the Study:
- To evaluate the implementation and coverage of new NBS programs for CH over the last decade.
- To assess current screening methods and coverage rates for CH globally.
- To provide an updated assessment of worldwide iodine status.
Main Methods:
- A comprehensive literature review was conducted using PubMed, Embase, and Google searches.
- Data on NBS programs for CH and their respective coverage rates were systematically collected for each country.
- Information on global iodine status was also compiled and analyzed.
Main Results:
- Global NBS coverage for CH has slightly increased to 29.6%.
- Efficient programs with optimal coverage exist in Europe, North America, Oceania, China, Japan, and Israel.
- Significant improvements in coverage are noted in Asia and South America, while Africa largely lacks widespread programs. Global iodine sufficiency has improved, with 149 countries achieving adequate levels by 2023.
Conclusions:
- While many countries have launched or expanded NBS programs for CH, approximately 70% of newborns worldwide still lack access.
- The majority of unscreened infants are concentrated in African and Asian countries.
- Continued efforts are needed to achieve universal NBS for CH, especially in underserved regions.
Background:
Congenital hypothyroidism (CH) is a preventable cause of neurodevelopmental delay in children, detectable by newborn screening (NBS) programs for CH. Since NBS for CH was started in Canada in 1974, numerous countries have successfully implemented this public health strategy. However, in 2014, only 29.3% of newborns worldwide were screened by NBS for CH.
Objective:
This study aimed to assess the implementation of new NBS programs for CH over the past decade, and screening methods and coverage rates of current programs. In addition, it sought to update the worldwide iodine status.
Methods:
We reviewed literature data on NBS programs for CH and their coverage rates for each country, using PubMed, Embase and Google searches.
Results:
Currently, 29.6% of children worldwide are screened for CH. Europe, North America, Oceania, China, Japan and Israel have efficient programs with optimal coverage. Recently, some countries of Central and Western Asia have implemented NBS programs for CH, and coverage has increased in several Asian countries. South America has also seen substantial improvements in coverage. In contrast, almost none of the African countries has widespread screening programs, but some attempts with pilot studies and local initiatives have been witnessed. Global iodine sufficiency has improved, with 149 of 193 countries achieving adequate iodine levels by 2023.
Conclusions:
Over the past decades, several countries have launched NBS programs for CH or conducted pilot studies, and the coverage of most existing NBS programs has increased. Nevertheless, approximately 70% of newborns worldwide still lack access to NBS for CH, predominantly in African and Asian countries, accounting for a significant part of annual births.
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