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The Netherlands
Area of Science:
- Neonatal screening
- Endocrinology
- Public health
Context:
- Nation-wide screening for congenital hypothyroidism (CH) in the Netherlands commenced in January 1981.
- The screening program utilizes a combined thyroxine (T4) and thyroid-stimulating hormone (TSH) method.
- Over 99% of newborns are included in the screening process.
Purpose:
- To detect all forms of congenital hypothyroidism, including primary, secondary, and tertiary.
- To improve the accuracy of screening by adjusting follow-up indications for premature infants.
- To assess the long-term developmental impact of early CH treatment.
Summary:
- The congenital hypothyroidism (CH) screening program in the Netherlands, initiated in 1981, uses a T4-TSH method covering over 99% of newborns.
- Adjustments in 1982 reduced false-positive rates in premature infants, and treatment initiation has been significantly advanced despite some delays.
- Ongoing research will evaluate the neurodevelopmental benefits of early CH intervention.
Impact:
- Reduced incidence of central nervous system damage in infants diagnosed with congenital hypothyroidism.
- Improved diagnostic accuracy and efficiency in neonatal screening protocols.
- Enhanced understanding of the long-term outcomes associated with timely CH treatment.
Abstract:
In the Netherlands nation-wide screening for CH began in January 1981. The aim of the combined T4-TSH screening method is to detect all forms of CH, primary as well as secondary and tertiary. More than 99% of the newborns are screened. The rate of false-positives in premature infants was reduced in June 1982 by a change of the indications for follow-up. Further study is performed on T4 values of premature infants. The information, given to the parents in case of recall, is not optimal yet. Although there is still delay in screening and follow-up, the initiation of treatment is considerably advanced. The effect of earlier treatment on development will be assessed by Prof. Dr. A. F. Kalverboer. Very likely, the early treatment will lead to a considerable reduction of damage to the central nervous system.