Abstract
Introduction: Congenital hypothyroidism is one of the most common preventable causes of mental retardation. The clinical manifestations are so subtle that many newborns are undiagnosed at birth.
Aim of study: Studying neonatal screening in Baghdad city and cases of hypothyroidism in screened infants, regarding; clinical presentation, treatment and follow up of cases.
Patients and methods: A retrospective descriptive study was done in Baghdad city for babies screened over the period 1st of Nov 2015 to 31st of Jan 2016. Data about screening program was collected over the period of 1st April 2013 to 31st October 2015 and 1st May 2013 to 31st October 2015 respectively.
Results: The total number of screened newborns was 441206 (249835 in Al-Rusafa and 191371 newborns in Al-Karkh) with average screening coverage of 59.9%. The overall proportion of occurrence of congenital hypothyroidism was 1:2141, phenylketonuria 1:6787, and galactosemia 1:21009. The study group included screened newborns patients from Al-Karkh hospitals (24 patients). The female : Male ratio patients in Al-Karkh was 1.6:1. There was a significant association of positive linear growth increment in symptomatic group of patients (P 0.044). A positive change in linear growth showed significantly younger aged patients (P 0.025) and higher admission TSH level than no change (P 0.001). There was a significantly higher level of admission TSH in delayed developmental milestone in the study group of patients (P 0.016).
Conclusion: *Efforts to bypass the drawbacks of work routines
*Enhance and encourage public education for notification of confirmed cases to attend tertiary centers
Key words: neonatal screening, hypothyroidism, development assessment, thyroxine, clinical features
References
1. U.S. Agency for International Development. National Guideline of Newborn Screening for Care Providers in PHC Centers. Iraq 2014. 45p. http://phciraq.org/www.usaid.gov
2. Aneela Anjum, Muhammad Faheem Afzal, Syed Muhammad Javed Iqbal, Muhammad Ashraf Sultan, and Asif Hanif.
3. Stephen H. LaFranchi and Stephen A. Huang, Stephen A. Huang. Hypothyroidism. In Robert M. Kliegman, and Richard E. Behrman, Nelson TEXTBOOK of PEDIATRICS, Ed 20, 2016, Elsevier Inc. Chapter 565, 2665-68
4. National Center for Health Statistics in collaboration with the National Center for Chronic Disease Prevention and Health Promotion. http://www.cdc.gov/growthcharts. modified 4/20/01
5. Dabbous NI, Abd El-Aziz HM, Abou El-Enein NY, Kandil HH, El-Kafoury AA. Indicators of the screening program for congenital hypothyroidism in alexandria. J Egypt Public Health Assoc. 2008;83(3-4):307-27.
6. Hwu WL, Huang AC, Chen JS, Hsiao KJ, Tsai WY. Neonatal screening and monitoring system in Taiwan. Southeast Asian J Trop Med Public Health. 2003;34 Suppl 3:91-3.
7. Stranieri I, Takano OA. Evaluation of the Neonatal Screening Program for congenital hypothyroidism and phenylketonuria in the State of Mato Grosso, Brazil. Arq Bras Endocrinol Metabol. 2009 Jun;53(4):446-52.
8. Anastasovska V, Koviloska R, Kocova M. High incidence of congenital hypothyroidism in one region of the republic of macedonia. Balkan J Med Genet. 2014 Dec 11;17(1):31-6.
9. Al-Maghamsi MS, Al-Hawsawi ZM, Ghulam GN, Okasha AM. Screening for congenital hypothyroidism in North-West region of Saudi Arabia. Saudi Med J. 2002; 23:1518-21
10. Pollitt RJ, Green A, Mc Cabe CJ. Neonatal screening for inborn errors of metabolism: cost, yield and outcome review. Health Technology Assessment. 1997; 1 (7). Available: www.ncchta.org.
11. American Academy of Pediatrics. Update of newborn screening and therapy for congenital hypothyroidism. Pediatrics. 2006; 117: 2290-303
12. Rastogi MV, LaFranchi SH. Congenital hypothyroidism. Orphanet J Rare Dis. 2010 Jun 10;5:17
13. Brown AL, Fernhoff PM, Milner J, McEwen C, Elsas LS. Racial differences in the incidence of congenital hypothyroidism. The Journal of pediatrics 1981; 99:934-936
14. Rosenthal M, Addison GM, Price DA. Congenital hypothyroidism: increased incidence in Asian families. Arch Dis Child 1988; 63:790-793
15. Hassan FA, El-Mougy F, Sharaf SA, Mandour I, Morgan MF, Selim LA, et al. Inborn errors of metabolism detectable by tandem mass spectrometry in Egypt: The first newborn screening pilot study. J Med Screen. 2016 Jan 20.
16. Waldemar A. Carlo. The newborn infant, in Robert M. Kliegman, and Richard E. Behrman, Nelson TEXTBOOK of PEDIATRICS, Ed 20, 2016, Elsevier Inc. Chapter 94, 794-802
17. Priya S. Kishnani and Yuan-Tsong Chen. Defects in Galactose Metabolism. In Robert M. Kliegman, and Richard E. Behrman, Nelson TEXTBOOK of PEDIATRICS, Ed 20, 2016, Elsevier Inc. Chapter 87.2, 726-27
18. Rezaeian S, Moghimbeigi A, Esmailnasab N. Gender differences in risk factors of congenital hypothyroidism: an interaction hypothesis examination. Int J Endocrinol Metab. 2014 Apr 1;12(2):e13946.
19. Abdelmoktader AM. Risk factors for congenital hypothyroidism in Egypt: results of a population case-control study (2003-2010). Ann Saudi Med. 2013 May-Jun;33(3):273-6. doi: 10.5144/0256-4947.2013.273.
20. Immacolata Cristina Nettore, Gianfranco Fenzi, and Paolo E. Macchia. Genetic Defects in Thyroid Hormone Supply. In Endotext [Internet]. De Groot LJ, Beck-Peccoz P, Chrousos G, et al., editors. South Dartmouth (MA): MDText.com, Inc.; 2000
21. Maynika V, Rastogi and Stephen H LaFranchi. Congenital hypothyroidism. Orphanet J Rare Dis. 2010; 5: 17. Published online 2010 Jun 10.
22. Castanet M, Polak M, Bonaiti-Pellie C, Lyonnet S, Czernichow P, Leger J. Nineteen years of national screening for congenital hypothyroidism: familial cases with thyroid dysgenesis suggest the involvement of genetic factors. The Journal of clinical endocrinology and metabolism 2001; 86:2009-2014
23. Büyükgebiz A. Newborn screening for congenital hypothyroidism. J Pediatr Endocrinol Metab. 2006 Nov;19(11):1291-8.
24. Rastogi MV, LaFranchi SH. Congenital hypothyroidism. Orphanet J Rare Dis. 2010 Jun 10;5:17.
25. Rosalind S. Brown, Disorders of the Thyroid Gland in Infancy, Childhood and Adolescence. http://www.ncbi.nlm.nih.gov/books/NBK279032/ Last Update: March 21, 2012.
26. Van Vliet G, Czernichow P. Screening for neonatal endocrinopathies: rationale, methods and results. Semin Neonatol. 2004 Feb;9(1):75-85.
27. Agrawal P, Philip R, Saran S, Gutch M, Razi MS, Agroiya P, et al. Congenital hypothyroidism. Indian J Endocrinol Metab. 2015 Mar-Apr;19(2):221-7
28. Minamitani K, Inomata H. Neonatal screening for congenital hypothyroidism in Japan. Pediatr Endocrinol Rev. 2012 Oct;10 Suppl 1:79-88.
DOI: http://dx.doi.org/10.18535/jmscr/v4i4.45
