Skip to main content
SpringerLink
Log in

Neonatal screening for congenital hypothyroidism in a developing country: problems and strategies

  • Original Articles
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Neonatal screening in India poses more organisational and socio-economic rather than medical challenges. Based on the pilot study of 450 cord sera, the plan for screening considered cord TSH<30 μU/ml as normal, 30 to 80 as borderline with recall by letters and >80 as indicative of hypothyroid state, with recall by home visits. Of the 17,240 live births only 12,407 cord sera were collected. Envisaging follow-up difficulties, T4 was assayed in cord sera when TSH was>30 μ U/ml. 2·81% (350) babies needed recall. Only 30% of 302 (2·43%) babies with cord TSG 30 to 80 responded, to recall letters and were normal; availability of both cord TSH and T4 helped in excluding hypothyroidism in majority of non-respondents. Forty-eight (0·38%) newborns had TSH>90 μU/ml; 80% of this group and 100% with TSH> 100 μU/ml were traced by home visits. Hypothyroidism was confirmed in 5/48, biochemically and by thyroid scan. All five hypothyroids had cord TSH>300 μU/ml. The incidence in this nonendemic region of India was 1∶2481. Thus false elevation of cord TSH 30 to 300 μU/ml was noted in 0·34% with a chance of detecting a hypothyroid 1 in 10 when TSH>80 μU/ml. Screening strategies in a developing country must ensure meticulous clerical assistance, co-operation and education of nurses and parents, precise and cost effective technics and facilities for continued surveilance of detected hypothyroids.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Desai MP, Sheth AR, Vishwanath T, Raikar RS. Thyroid stimulating hormone (TSH) in the newborn.Indian J Med Res 1979;69: 128–135

    PubMed  CAS  Google Scholar 

  2. Midgley AT Jr. Radioimmunoassay: A method for human chorionic gonadotropin and human Luteinizning hormone.Endocrinology 1966;79: 10–18

    PubMed  CAS  Google Scholar 

  3. Hulse JA, Grant DB, Clayton BE, Lilly P. et al. Population screening for congenital hypothyroidism.Br Med J 1980;280: 675–678

    Article  PubMed  CAS  Google Scholar 

  4. Hulse JA, Grant DB, Jackson D, Clayton BE. Growth development and reassessment of hypothyroid infant diagnosed by screening.Br Med J 1982;284: 1435–1439

    CAS  Google Scholar 

  5. Glorieux J, Dussault JH, Letarte J, Guyda H, Morissette J. Preliminary results on the mental development of hypothyroid infants detected by the Quebec Screening.Program J Pediatr 1983;102: 19–22

    CAS  Google Scholar 

  6. Glorieux J, Dussault JH, Morissette J, Desjardins M, Letarte J, Guyda H. Follow-up at ages 5 and 7 years on mental development in children with hypothyroidism detected by Quebec Screening.Program J Pediatr 1985;107: 913–915

    CAS  Google Scholar 

  7. New England congenital hypothyroidism collaborative. Characteristics of infantile hypothyroidism discovered on neonatal screening.J Pediatr 1984;104: 539–544

    Google Scholar 

  8. Pandav CS, Kochupillai N. Organisation and implementation of neonatal hypothyroid screening programme in India—a primary health care approach.Indian J Pediatr 1985;52: 223–229

    PubMed  CAS  Google Scholar 

  9. Colaco MP, Desai MP, Ajgaonkar AR et al. Neonatal screening for hypothyroidism.Indian Pediatr 1984;21: 695: 700

    PubMed  CAS  Google Scholar 

  10. Gendrel D, Feinstein MC, Grenier J et al. Falsely elevated serum thyrotropin (TSH) in newborn infants: Transfer from mothers to infants of a factor interfering in the TSH radioimmunoassay.J Clin Endocrinol Metab 1981;52: 62–65

    PubMed  CAS  Google Scholar 

  11. Czernichow P, Vandalem JL, Hennen G. Transient neonatal hyperthyrotropinemia: A factitious syndrome due to the presence of heterophilic antibodies in the plasma of infants and their mothers.J Clin Endocrinol Metab 1981;53: 387–393

    Article  PubMed  CAS  Google Scholar 

  12. John R, Lazams JH, Ginsberg J, Hughes IA, Shewring G, Woodhend JS.Falsely elevated serum thyrotropin in a neonate and mother in neonatal screening. In: Naruse H, Irie M. ed. Excerpta Medical International Congress Series 1983:606: p. 50–51

  13. Spitz IM, LeRoith D, Hirsch H et al. Increased high molecular—weight thyrotropin with impaired biologic activity in a euthyroid man.New Engl J Med 1981;304: 278–282

    Article  PubMed  CAS  Google Scholar 

  14. Miyai K, Harada T, Nose O, Mizuta H, Anup N, Yabunchi H.Hyperthyrotropinemia with normal thyroid hormone concentration in newborn babies. In: Neonatal Screening. Naruse H, Irie M. ed. Excerpta Medica International Congress Series 1983;606: 44–49

  15. Gruters A, Allemond D, Heidemann P, Helge H. Thyroid function and odine concentrations in newborns and their mothers after vaginal PVP.Iodine treatment in obstetrics. Excerpta Medica International Congress Series 1983;606: p. 54–55

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Bai Jerbai Wadia Hospital for Children and Institute of Child Health, Acharya Donde Marg, Parel, 400012, Bombay

    M. P. Desai, M. P. Colaco, A. R. Ajgaonkar, C. V. Mahadik, F. E. Vas, C. Rege, V. V. Shirodkar, A. Bandivdekar & A. R. Sheth

  2. Institute for Research in Reproduction (ICMR), Bombay

    M. P. Desai, M. P. Colaco, A. R. Ajgaonkar, C. V. Mahadik, F. E. Vas, C. Rege, V. V. Shirodkar, A. Bandivdekar & A. R. Sheth

Authors
  1. M. P. Desai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. P. Colaco
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. R. Ajgaonkar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. V. Mahadik
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. F. E. Vas
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C. Rege
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. V. V. Shirodkar
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. Bandivdekar
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. A. R. Sheth
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Desai, M.P., Colaco, M.P., Ajgaonkar, A.R. et al. Neonatal screening for congenital hypothyroidism in a developing country: problems and strategies. Indian J Pediatr 54, 571–581 (1987). https://doi.org/10.1007/BF02749056

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02749056

Keywords

Search

Navigation