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Screening for congenital hypothyroidism by using cord blood thyroid stimulating hormone (CBTSH) levels in neonates
Laxmi Gudaganatti1, Sangamma G Sajjan1, Romana Khursheed2
1Department of Biochemistry, KAHER, J.N. Medical College, Belagavi, Karnataka, India.
Insights
Newborn screening for congenital hypothyroidism (CH) is vital. This study found that maternal complications and certain neonatal factors, like prematurity, are linked to higher cord blood Thyroid-Stimulating Hormone (TSH) levels, aiding early CH detection.
Area of Science:
- Neonatal Medicine
- Endocrinology
- Public Health
Background:
- Congenital hypothyroidism (CH) is a leading preventable cause of intellectual disability in children.
- Early detection through newborn screening is crucial to prevent severe developmental outcomes.
- Thyroid-Stimulating Hormone (TSH) screening in cord blood is a key method for identifying CH.
Purpose of the Study:
- To assess the incidence of CH using cord blood TSH (CBTSH) levels.
- To investigate the impact of maternal and perinatal factors on CBTSH levels.
Main Methods:
- A cross-sectional study involving 106 neonates in urban south Karnataka, India.
- Umbilical cord blood samples were analyzed for CBTSH using electrochemiluminescence.
- Statistical analysis was performed to determine associations.
Main Results:
- The mean CBTSH level was 6.20 ± 5.90 μIU/ml.
- Significant associations were found between CBTSH levels and maternal complications (age, delivery mode, gravida, prenatal hypothyroidism).
- Higher CBTSH levels were observed in preterm infants, those with Apgar scores <7, vaginal deliveries, primigravida mothers, males, and low-birth-weight neonates.
Conclusions:
- Maternal health issues significantly correlate with CBTSH levels.
- Specific neonatal characteristics, including prematurity and low birth weight, are associated with elevated CBTSH, highlighting risk factors for CH.
Background:
Congenital hypothyroidism (CH) is the most common preventable cause of mental retardation in children. Hypothyroidism in the neonatal period is always overlooked, and delayed discovery results in the most devastating outcomes, such as mental retardation, stressing the importance of newborn screening, which is one of the major achievements in preventive medicine. According to previous studies, Thyroid-Stimulating Hormone (TSH) screening is more specific for identifying CH. TSH levels in umbilical cord blood remain an easy and useful means to screen for congenital hypothyroidism, and it is widely documented that maternal and neonatal factors influence Cord Blood Thyroid Stimulating Hormone (CBTSH) levels. The current study was conducted to screen for and determine the effects of various perinatal and maternal variables on CBTSH levels.
Objectives:
To evaluate the incidence of congenital hypothyroidism using CBTSH) levels and to examine the influence of maternal and perinatal factors on these levels.
Material And Methods:
This cross-sectional study included 106 neonates. Samples were collected from the neonatal ward of a tertiary care hospital in urban south Karnataka, India. An umbilical cord blood sample was collected, and the CBTSH assay was performed using the electrochemiluminescence method. The data obtained were statistically analyzed.
Result:
In the present study, the mean cord blood TSH level was 6.20 ± 5.90 μIU/ml. There was a statistically significant association between the mean CBTSH level and maternal complications (Age, mode of delivery, gravida, and prenatal hypothyroidism status). A higher CBTSH level was found in preterm babies with an APGAR score of <7, vaginal deliveries, primigravida, male sex, and low-birth-weight babies.
Conclusion:
This study found a significant association between CBTSH levels and maternal health problems. Preterm newborns with an appearance, pulse, grimace, activity, and respiration score of <7, normal vaginal delivery, primigravida, male sex, and low birth weight had higher CBTSH levels.
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