Subscribe to RSS
Evaluation of the Congenital Hypothyroidism Detection Strategy in Extremely Preterm Infants in Western Andalusia
Objective This study aimed to identify extremely premature infants (< 31 weeks of gestation and/or <1,500 g) affected by congenital hypothyroidism (CH) with delayed elevation of thyrotropin (TSH) and to evaluate the detection strategy for this pathology in our reference screening population.
Study Design A descriptive and retrospective study was carried out with samples collected from western Andalusia and the autonomous city of Ceuta.
Results This protocol allowed us to detect six neonates with delayed TSH elevation. One of them, due to serious heart problems, died without being able to confirm CH. In two neonates, however, it was possible to detect CH, another two presented a persistent TSH elevation but normal free T4, and another one presented a temporary TSH elevation.
Conclusion It is essential to repeat the CH screening in extremely premature infants, not only at the age of 15 days but also with a third sample at the moment of hospital discharge to detect cases with delayed TSH elevation.
The Newborn Screening Programs are an essential activity of preventive medicine.
Extremely preterm infants have a very high risk of CH.
Optimal management of thyroid dysfunction in this population remains to be established.
Received: 26 March 2021
Accepted: 27 August 2021
31 August 2021 (online)
© 2021. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
- 1 Couce ML. [Fifty years of neonatal screening for congenital diseases in Spain]. An Pediatr (Engl Ed) 2019; 90 (04) 205-206
- 2 Grosse SD, Van Vliet G. Prevention of intellectual disability through screening for congenital hypothyroidism: how much and at what level?. Arch Dis Child 2011; 96 (04) 374-379
- 3 Marín JL, Aldamiz-Echevarría L, Castiñeiras DE. et al. Programas de cribado neonatal en España: Actualización y propuestas de futuro. Documento de consenso. Real Patronato sobre Discapacidad. Ministerio de Sanidad y Política Social; 2009
- 4 Léger J, Olivieri A, Donaldson M. et al; ESPE-PES-SLEP-JSPE-APEG-APPES-ISPAE, Congenital Hypothyroidism Consensus Conference Group. European Society for Paediatric Endocrinology consensus guidelines on screening, diagnosis, and management of congenital hypothyroidism. J Clin Endocrinol Metab 2014; 99 (02) 363-384
- 5 Cherella CE, Wassner AJ. Congenital hypothyroidism: insights into pathogenesis and treatment. Int J Pediatr Endocrinol 2017; 2017: 11
- 6 Camino R, Delgado C, García R. et al. Programa de cribado neonatal de enfermedades endocrino-metabólicas de Andalucía. Instrucciones para profesionales. Consejería de Salud. Servicio Andaluz de Salud; 2016
- 7 LaFranchi SH. Screening preterm infants for congenital hypothyroidism: better the second time around. J Pediatr 2014; 164 (06) 1259-1261
- 8 Kaluarachchi DC, Allen DB, Eickhoff JC, Dawe SJ, Baker MW. Increased congenital hypothyroidism detection in preterm infants with serial newborn screening. J Pediatr 2019; 207: 220-225
- 9 Chung HR. Screening and management of thyroid dysfunction in preterm infants. Ann Pediatr Endocrinol Metab 2019; 24 (01) 15-21
- 10 World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013; 310 (20) 2191-2194
- 11 Calaciura F, Motta RM, Miscio G. et al. Subclinical hypothyroidism in early childhood: a frequent outcome of transient neonatal hyperthyrotropinemia. J Clin Endocrinol Metab 2002; 87 (07) 3209-3214
- 12 Delgado-Pecellín C, Álvarez AI, Bueno MA. et al. Resultados del cribado neonatal de Andalucía Occidental tras una década de experiencia. Rev Esp Salud Pública 2020; 94: 1-12
- 13 McGrath N, Hawkes CP, Mayne P, Murphy NP. Optimal timing of repeat newborn screening for congenital hypothyroidism in preterm infants to detect delayed thyroid-stimulating hormone elevation. J Pediatr 2019; 205: 77-82
- 14 Korada M, Pearce MS, Ward Platt MP. et al. Repeat testing for congenital hypothyroidism in preterm infants is unnecessary with an appropriate thyroid stimulating hormone threshold. Arch Dis Child Fetal Neonatal Ed 2008; 93 (04) F286-F288
- 15 Vincent MA, Rodd C, Dussault JH, Van Vliet G. Very low birth weight newborns do not need repeat screening for congenital hypothyroidism. J Pediatr 2002; 140 (03) 311-314
- 16 Hashemipour M, Hovsepian S, Ansari A, Keikha M, Khalighinejad P, Niknam N. Screening of congenital hypothyroidism in preterm, low birth weight and very low birth weight neonates: a systematic review. Pediatr Neonatol 2018; 59 (01) 3-14
- 17 Cavarzere P, Camilot M, Popa FI. et al. Congenital hypothyroidism with delayed TSH elevation in low-birth-weight infants: incidence, diagnosis and management. Eur J Endocrinol 2016; 175 (05) 395-402