McGovern Matthew, Reyani Zahra, O'Connor Pamela, White Martin, Miletin Jan
Coombe Women and Infants University Hospital, Dublin, Ireland.
Royal College of Surgeons, Dublin, Ireland.
Eur J Pediatr. 2016 Dec;175(12):2015-2018. doi: 10.1007/s00431-016-2793-8. Epub 2016 Oct 14.
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.
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.
我们的目的是评估在出生后10 - 14天检测血清甲状腺素和促甲状腺激素对诊断甲状腺功能减退母亲所生婴儿先天性甲状腺功能减退症(CH)的效用。这是一项对一家三级新生儿转诊中心12个月内出生的所有婴儿进行的回顾性研究。纳入在研究期间因母亲甲状腺功能减退而在出生后10 - 14天进行甲状腺功能测试(TFT)的婴儿。记录新生儿血斑检测结果、出生后10 - 14天的TFT结果以及患者是否接受后续治疗。在纳入研究的319例患者中,仅发现2例患有CH,且这两例新生儿血斑检测结果均异常。
出生后10 - 14天的甲状腺检测未发现额外的CH病例,鉴于现有新生儿筛查项目的稳健性,应停止这种做法。已知信息:• 先天性甲状腺功能减退症(CH)是儿童智力障碍最常见的可预防病因。• 甲状腺功能减退症家族史被认为是CH的一个危险因素。• 自20世纪70年代以来,CH一直是新生儿筛查的一部分。新发现:• 尚无研究推荐在出生后10 - 14天进行甲状腺功能测试以检测甲状腺功能减退母亲所生新生儿的CH。• 出生后10 - 14天进行甲状腺功能测试并不能提高甲状腺功能减退母亲所生婴儿CH的诊断率。• 新生儿血斑仍然是准确及时诊断CH的主要手段。