Congenital hypothyroidism screening in Oklahoma: a change in follow-up recommendations for 1999

Effective January 1999, the Newborn Metabolic Disorder Screening Follow-up Program of the Oklahoma State Department of Health will no longer track hypothyroidism screen results of one abnormal T4 with normal TSH result. The Oklahoma State Department of Health Newborn Metabolic Disorder Screening Program (NMDSP) began screening for congenital hypothyroidism (CH) in 1979 and has subsequently identified 159 affected newborns. In 1997, Oklahoma had 46,740 live births, 51,431 specimens submitted to NMDSP Laboratory for screening, 1,302 infants identified with an abnormal thyroid screen, and 11 infants diagnosed with CH with an average treatment age of 23.2 days (see Table 1). The NMDSP identifies an average of 14 CH cases each year. The pediatric health care provider can anticipate that in his/her practice, one out of 64 infants will be identified with an abnormal T4 with normal TSH result, and one out of 82 will be identified with an abnormal TSH value. In summary, one out of 36 infants will have some degree of abnormality on the thyroid screen.