Mansour Chourouk, Ouarezki Yasmine, Jones Jeremy, Fitch Moira, Smith Sarah, Mason Avril, Donaldson Malcolm
Hôpital Universitaire d'Enfants Abderrahim Harouchi, Casablanca, Morocco.
Etablissement Public Hospitalier Hassen-Badi, El-Harrach, Algiers, Algeria.
Arch Dis Child. 2017 Oct;102(10):936-941. doi: 10.1136/archdischild-2016-312156. Epub 2017 Jun 9.
To determine ages at first capillary sampling and notification and age at notification after second sampling in Scottish newborns referred with elevated thyroid-stimulating hormone (TSH).
Referrals between 1980 and 2014 inclusive were grouped into seven 5-year blocks and analysed according to agreed standards.
Of 2 116 132 newborn infants screened, 919 were referred with capillary TSH elevation ≥8 mU/L of whom 624 had definite (606) or probable (18) congenital hypothyroidism. Median age at first sampling fell from 7 to 5 days between 1980 and 2014 (standard 4-7 days), with 22, 8 and 3 infants sampled >7 days during 2000-2004, 2005-2009 and 2010-2014. Median age at notification was consistently ≤14 days, range falling during 2000-2004, 2005-2009 and 2010-2014 from 6 to 78, 7-52 and 7-32 days with 12 (14.6%), 6 (5.6%) and 5 (4.3%) infants notified >14 days. However 18/123 (14.6%) of infants undergoing second sampling from 2000 onwards breached the ≤26-day standard for notification. By 2010-2014, the 91 infants with confirmed congenital hypothyroidism had shown favourable median age at first sample (5 days) with start of treatment (10.5 days) approaching age at notification.
Most standards for newborn thyroid screening are being met by the Scottish programme, but there is a need to reduce age range at notification, particularly following second sampling. Strategies to improve screening performance include carrying out initial capillary sampling as close to 96 hours as possible; introducing 6-day laboratory reporting and use of electronic transmission for communicating repeat requests.
确定因促甲状腺激素（TSH）升高而被转诊的苏格兰新生儿首次进行毛细血管采血及通知的年龄，以及第二次采血后通知的年龄。
将1980年至2014年（含）期间的转诊病例分为7个5年组，并按照商定的标准进行分析。
在2116132例接受筛查的新生儿中，919例因毛细血管TSH升高≥8 mU/L而被转诊，其中624例患有明确（606例）或可能（18例）的先天性甲状腺功能减退症。1980年至2014年期间，首次采血的中位年龄从7天降至5天（标准为4 - 7天），在2000 - 2004年、2005 - 2009年和2010 - 2014年期间，分别有22例、8例和3例婴儿在>7天时采血。通知的中位年龄始终≤14天，在2000 - 2004年、2005 - 2009年和2010 - 2014年期间，范围从6至78天、7至52天和7至32天下降，分别有12例（14.6%）、6例（5.6%）和5例（4.3%）婴儿在>14天时被通知。然而，2000年起接受第二次采血的婴儿中有18/123（14.6%）违反了≤26天的通知标准。到2010 - 2014年，91例确诊先天性甲状腺功能减退症的婴儿首次采样的中位年龄（5天）良好，治疗开始时间（10.5天）接近通知年龄。
苏格兰的新生儿甲状腺筛查项目大多符合标准，但有必要缩小通知的年龄范围，尤其是在第二次采血之后。提高筛查性能的策略包括尽可能在接近96小时时进行首次毛细血管采血；引入6天的实验室报告，并使用电子传输来传达重复请求。
