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Thyroid screening for early discharged infants

J G Saslow1, E M Post, C A Southard

  • 1Children's Regional Hospital, Robert Wood Johnson Medical School at Camden, New Jersey, USA.

Pediatrics
|July 1, 1996
PubMed
Summary
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Early newborn screening for congenital hypothyroidism (CH) using specimens collected within 24 hours is feasible for infants over 2500g. This approach significantly reduces repeat testing while maintaining accuracy, avoiding false negatives.

Area of Science:

  • Neonatal screening
  • Endocrinology
  • Public health

Background:

  • Neonatal discharge before 24 hours is common.
  • Early screening specimens are often rejected, increasing testing needs.
  • Congenital hypothyroidism (CH) screening is critical for early intervention.

Purpose of the Study:

  • To evaluate the safety and efficacy of using neonatal screening specimens collected before 24 hours of life.
  • To determine if early specimens can be safely utilized to reduce repeat testing.

Main Methods:

  • Thyrotropin (TSH) levels were measured in screening specimens collected before 24 hours.
  • Early specimens were analyzed from infants diagnosed with CH in New Jersey (1993-1994).
  • Specimens were categorized by collection time (≤12 hours, >12-24 hours) and infant weight (≥2500g, <2500g).

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Main Results:

  • Specimens collected ≤12 hours or from infants <2500g were unreliable due to low thyroxine.
  • For infants ≥2500g with specimens >12-24 hours, 7% had low thyroxine and 2.3% had TSH ≥20 μIU/mL.
  • No infants ≥2500g diagnosed with CH had normal early (<24 hours) screening results.
  • Subsequent specimens (after 24 hours) for the 515 infants showed no abnormalities.

Conclusions:

  • Accepting specimens collected >12-24 hours for infants ≥2500g could increase false positives but prevent false negatives.
  • This strategy could reduce requests for additional specimens by over 90%.
  • Early screening within 24 hours is a viable option for specific neonatal populations.