Abstract

SCREENING FOR CONGENITAL HYPOTHYROIDISM IN GREATER NOIDA BY MEASUREMENT OF UMBILICAL CORD THYROXINE (FREE) AND THYROID STIMULATING HORMONE: A MULTICENTRIC HOSPITAL BASED STUDY

Chandra Prakash Sharma, Widhi Dubey and Dr. Suryakant Nagtilak*

Abstract

Introduction: Congenital hypothyroidism (CH) is the deficiency ofthyroid hormone present at birth. It is most commonly caused by thepoor development of the thyroid gland or disorder in the production ofthyroid hormone. CH is of two types namely permanent and transientCH. Permanent CH associated with deficiency of thyroid hormoneswhich requires life- long treatment but Transient CH associated withtemporary deficiency of thyroid hormones, find out at the time of birth,but in the transient CH the treatment will be continued till recoveringto normal thyroid hormones production. Aim: To screen the neonatesfor congenital hypothyroidism (CH) by measuring Umbilical cordblood Thyroid Stimulating Hormone (TSH) and T4 (free) levels inneonates. Materials and Methods: The present multicentric hospitalbased study carried out in the tertiary care centres of Greater Noida,Gautam Budha Nagar district. It is based on the findings of Umbilicalcord blood to screen the CH whose mothers having no known history of thyroid disorders.Umbilical cord blood TSH and T4 (free) levels were analyzed to screen the neonates forpresence of CH in study area. Results: Observed mean ±SD in umbilical cord blood T4 (free)1.14±0.30 ng/dl and TSH 10.14±6.14 uIU/ml in neonates patients. Nearly 30.48% of thesamples showed levels of TSH >10.0 uIU/ml. Two neonates were found as transient hypothyroidism, out of 82 neonates whereas not a single neonate detected as permanent hypothyroidism. Conclusion: The present study highlights the importance of neonatal screening programme for the dysfunctions of thyroid gland. Higher prevalence of CH in India may be due to lack of awareness & poor infrastructure. Total 82 neonates screened for the presence of CH in which 39 neonates (47.56%) were male and 43 neonates (52.43%) were female. Out of these two neonates were finally confirmed as transient hypothyroid. To perform the more studies with more population helps as a best indicator of more precise evaluation of thyroid status in neonates. In most of the studies, only TSH levels monitored to ensure optimal neurocognitive outcome. The TSH and T4 (free) should be assayed to screen the neonates for CH. The CH detected neonates by screening kept on treatment as early as possible.

Keywords: Thyroid stimulating hormone, Thyroxin free, Congenital hypothyroidism, Screening, Umbilical cord blood.