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Screening for neonatal hypothyroidism in Israel during a 4-year period
Insights
Israel
Area of Science:
- Endocrinology
- Pediatrics
- Public Health
Background:
- Neonatal hypothyroidism (NH) screening is crucial for early detection and treatment.
- The Israeli NH screening program began in May 1978.
- Understanding the prevalence and causes of NH in the screened population is important.
Purpose of the Study:
- To evaluate the effectiveness of the neonatal hypothyroidism screening program in Israel.
- To determine the incidence and causes of NH in screened infants.
- To assess the impact of screening on the age of treatment initiation.
Main Methods:
- Screening of 538,565 infants between May 1978 and April 1984.
- Diagnosis of NH based on screening results.
- Thyroid scans performed on 51 neonates with NH to determine the cause.
- Analysis of treatment initiation timing and program limitations.
Main Results:
- 166 newborns diagnosed with NH, with 7 having transient hypothyroidism.
- Average age of treatment initiation decreased from 6 to 4.8 weeks.
- Thyroid scan results: 41% agenesis, 24% ectopic tissue, 29% dyshormonogenesis, 6% secondary/tertiary hypothyroidism.
- High incidence of dyshormonogenesis possibly linked to consanguinity.
Conclusions:
- Neonatal screening effectively detects infants with NH, enabling earlier treatment.
- The screening program in Israel has successfully reduced the age of treatment initiation.
- The study highlights the importance of screening programs for managing congenital hypothyroidism.
Abstract:
The neonatal hypothyroidism (NH) screening program in Israel was initiated in May 1978, and by the end of April 1984, 538,565 infants had been screened. One hundred sixty-six newborns were found to have NH; 7 of these exhibited only transient hypothyroidism. During the screening period the average age for initiation of treatment decreased from 6 to 4.8 weeks. A thyroid scan was performed on 51 of the neonates with NH; 41% had agenesis of the thyroid, 24% ectopic thyroid tissue, 29% dyshormonogenesis, and 6% secondary or tertiary hypothyroidism. This high incidence of dyshormonogenesis in Israel is probably due to a high rate of consanguinity among the Arab population and also within some of the Jewish ethnic groups. No blood sample was received from four infants with NH, and one infant with NH was not notified. This study indicates that a neonatal screening program can effectively detect infants with NH, resulting in earlier treatment.