Newborn screening for congenital hypothyreoidism(CH) in Georgia
N. Beridze1, R. Takaishvili1, T. Azikuri1, M. Mumladze1 & M. Iashvili2
Background and aim: Revelation of the incidence of CH is of great value at the background of iodine deficiency (ID) existing in Georgia. Screening on CH in our company with consequent monitoring of the newborns with neonatal hyperthyreotropinemia (NHT) started in September 2010.
Materials and methods: During the first year period 70 731 newborns from all over Georgia underwent TSH (mU/l) determination from blood spots, taken at 2472 h after birth and venous blood FT4 (ng/dl) and TSH at two weeks after birth using DELFIA kits were measured. Infants with NHT(cut off level 20 mU/l) were consulted by pediatrician, endocrinologist and their blood thyreoglobulin (TG) level(ng/dl) and thyroid volume (cm3), using ultrasound investigation were examined.
Results: Transitory NHT had 280 infants (1:253 live births), mediana 46.5(range 28.7210), boys 151, girls 129.23 infants had CH (1:3075 live births), girls -boys ratio-2,8/;ten with subclinical CH (Gr.1) and 13 -overt CH (Gr.2). Most of the babies were clinically euthyroid except 8.3% having prolonged jaundice, 5%-constipation, 3.3%-sleepiness and 0.33% macroglossia. Most of the mothers with high NHT did not receive iodide supplementation during pregnancy. No one received high doses of iodine or anti-thyroid drugs. Heredity for thyroid pathology ranged 3441%. No case of goiter and thyroid agenesis was detected. Gr.1 thyroid volume median- 1.3 was 2.6 times greater than of Gr.2- 0.5 (P<0.001) and their neonatal and 2-weeks TSH levels were lower compared to GR.2 P<O.O5. Two infants of Gr.2 with pronounced thyroid hypoplasia (volume 0.2 cm3) had low TG level-2.53.6. The rest had moderately elevated TG levels with median of Gr.2- 168.5, that was significantly higher compared to Gr.1- 72.1, P<0.01.
Conclusion: Thus, CH in Georgia develops without goiter and with marked hypoplasia in severe cases that is possibly conditioned by ID and hereditary predisposition to thyroid pathology.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This work was supported, however funding details unavailable.