Original ArticlesOptimal Timing of Repeat Newborn Screening for Congenital Hypothyroidism in Preterm Infants to Detect Delayed Thyroid-Stimulating Hormone Elevation
Section snippets
Methods
The Ethics Committee of the Children's University Hospital, Temple St approved this study. The population-based, prospective records of the Republic of Ireland's National Newborn Bloodspot Screening Program for congenital hypothyroidism, coordinated from the Children's University Hospital, Temple Street were reviewed.
Screening for congenital hypothyroidism in the Republic of Ireland consists of collection of whole-blood samples on filter paper following a heel-prick between 72 and 120 hours
Results
Between January 2004 and December 2016, a total of 898 424 infants were screened for congenital hypothyroidism in the Republic of Ireland, and of these, 586 infants were treated for congenital hypothyroidism (incidence, 1:1533 births). A total of 53 infants (11%) were <33 weeks of gestation. Gestational age in the preterm cohort ranged from 23 to 33 weeks (median, 29 weeks), and median birth weight was 1.2 kg (range, 0.46-3.16 kg). The median serum TSH concentration at diagnosis was 78.3 mU/L
Discussion
In this study, we have found that repeat screening for congenital hypothyroidism in preterm infants is necessary to avoid missing cases of permanent and decompensated hypothyroidism. One-half of the preterm infants diagnosed with congenital hypothyroidism were not diagnosed on initial newborn screening. Among the infants with delayed TSH rise, >40% had decompensated hypothyroidism at diagnosis, and >20% had permanent congenital hypothyroidism. Along with emphasizing the importance of repeat TSH
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N.M. receives support from The Children's Fund for Health, Children's University Hospital, Temple Street, Dublin. The authors declare no conflicts of interest.