Nanu M, Ardeleanu I S, Brezan F, Nanu I, Apostol A, Moldovanu F, Lazarescu H, Gheorghiu M L, Kozma A
"Alessandrescu-Rusescu" National Institute for Mother and Child Health - Research Department in Social Pediatry and Obstetrics, Bucuresti, Romania.
"Alessandrescu-Rusescu" National Institute for Mother and Child Health - The Technical Assistance and Management Unit of the National Programs PN-VI, Bucuresti, Romania.
Acta Endocrinol (Buchar). 2019 Apr-Jun;15(2):209-214. doi: 10.4183/aeb.2019.209.
Congenital hypothyroidism (CH) is one of the common preventable causes of intellectual disability in neonates, by early detection through neonatal screening. We present the 8-year experience of the National Institute for Mother and Child Health (INSMC) in using MEDILOG national registry for the neonatal screening of CH.
Neonatal screening for CH, done by TSH measurement in dried blood spot, is organized in 5 regional centers, each with a reference laboratory.
In 2018 80% of all the newborns, from 80% of the maternity hospitals, were registered in MEDILOG. After re-testing of TSH and T4/FT4 from venous blood in positive cases, the incidence of confirmed CH in 2018 was 1/3576 - 1/ 4746. In INSMC center (which includes 26 counties and Bucharest, out of 41 counties), in 2018 the incidence of positive CH cases at screening was 1/2094 (TSH cut-off ≥17 mIU/L) and of confirmed CH cases 1/3576 newborns. For positive screening cases, the median duration from birth to the INSMC laboratory result was 19 days: median of 9 days between screening and laboratory registration and 6 days between registration and test result.
MEDILOG registry is a practical instrument for monitoring the steps of neonatal CH screening, the incidence of CH, the evolution of the diagnosed cases, for evaluation of iodine deficiency (by neonatal TSH), and also for research, with the aim of improving early disease detection and treatment.
先天性甲状腺功能减退症(CH)是新生儿智力残疾常见的可预防病因之一,可通过新生儿筛查早期发现。我们介绍了国家妇幼健康研究所(INSMC)使用MEDILOG国家登记系统进行CH新生儿筛查的8年经验。
通过检测干血斑中的促甲状腺激素(TSH)进行CH新生儿筛查,在5个区域中心开展,每个中心都有一个参考实验室。
2018年,80%的妇产医院中80%的新生儿在MEDILOG登记。对阳性病例静脉血中的TSH和T4/FT4进行重新检测后,2018年确诊CH的发病率为1/3576 - 1/4746。在INSMC中心(包括41个县中的26个县和布加勒斯特),2018年筛查时CH阳性病例的发病率为1/2094(TSH临界值≥17 mIU/L),确诊CH病例的发病率为1/3576新生儿。对于筛查阳性病例,从出生到INSMC实验室出结果的中位时间为19天:筛查到实验室登记的中位时间为9天,登记到检测结果的中位时间为6天。
MEDILOG登记系统是监测新生儿CH筛查步骤、CH发病率、确诊病例进展情况、评估碘缺乏(通过新生儿TSH)以及进行研究的实用工具,目的是改善疾病的早期发现和治疗。