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Thyroid function testing in neonates born to women with hypothyroidism

European Journal of Pediatrics volume 175, pages 2015–2018 (2016)Cite this article

Abstract

Our aim was to assess the utility of serum thyroxine and thyroid stimulating hormone performed at 10–14 days of life in diagnosing congenital hypothyroidism (CH) in babies born to mothers with hypothyroidism. This was a retrospective study of all babies born in a tertiary referral centre for neonatology over a 12-month period. Infants who had thyroid function testing (TFT) checked at 10–14 days of life because of maternal hypothyroidism during the period of study were included. The results of the newborn bloodspot and day 10–14 TFT were recorded along with whether or not patients were subsequently treated. Of the 319 patients included in the study, only two patients were found to have CH and in both cases the newborn blood spot had been abnormal.

Conclusion: No extra cases of CH were detected from the thyroid test at 10–14 days and this practice should be discontinued due to the robust nature of existing newborn screening programmes.

What is Known:
• Congenital hypothyroidism(CH) is the commonest preventable cause of childhood intellectual impairment.
• Family history of hypothyroidism has been implicated as a risk factor for CH.
• CH has formed part of newborn screening since the 1970s.
What is New:
• There is no research recommending thyroid function testing at 10–14 days of life to detect CH in neonates born to mothers with hypothyroidism.
• Thyroid function testing at 10–14 days of life does not improve diagnostic yield for CH in babies born to mothers with hypothyroidism.
• Newborn blood spot remains the mainstay for accurate and timely diagnosis of CH.

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Abbreviations

(CH):

Congenital hypothyroidism

(TFT):

Thyroid function testing

(T4):

Thyroxine

(TSH):

Thyroid stimulating hormone

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Authors’ Contributions

All authors were involved in the design and planning of the research performed. M. McGovern was the primary investigator and performed the majority of data collection, analysis and presentation of data. Z. Reyani conducted data collection regarding newborn screening and reviewed this article before submission. P. O’Connor was involved in the design of the study and supervised data collection and analysis. M. White was involved in the design of the study and supervised data collection and analysis. J. Miletin was the overall project co-ordinator and oversaw all aspects of the project.

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Affiliations

  1. Coombe Women and Infants University Hospital, Dublin, Ireland

    Matthew McGovern, Zahra Reyani, Pamela O’Connor, Martin White & Jan Miletin

  2. Royal College of Surgeons, Dublin, Ireland

    Martin White

  3. Institute for the care of Mother and Child, Prague, Czech Republic

    Jan Miletin

  4. UCD School of Medicine and Medical Sciences, Dublin, Ireland

    Jan Miletin

  5. 3rd School of Medicine, Charles University, Prague, Czech Republic

    Jan Miletin

Authors
  1. Matthew McGovern
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  2. Zahra Reyani
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  3. Pamela O’Connor
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  4. Martin White
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  5. Jan Miletin
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Corresponding author

Correspondence to Matthew McGovern.

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Funding

This study received no funding of any type.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. As this study formed part of a departmental audit with regard to neonatal thyroid function testing formal ethical approval for access to patient records was not obtained from the departmental ethics board.

Informed consent

For this type of study formal consent is not required.

Additional information

Communicated by Patrick Van Reempts

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McGovern, M., Reyani, Z., O’Connor, P. et al. Thyroid function testing in neonates born to women with hypothyroidism. Eur J Pediatr 175, 2015–2018 (2016). https://doi.org/10.1007/s00431-016-2793-8

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  • DOI: https://doi.org/10.1007/s00431-016-2793-8

Keywords

  • Congenital hypothyroidism
  • Thyroid function tests
  • Infant
  • Newborn
  • Risk factors
  • Neonatal screening