Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, Ioannina, Greece.
Department of Pediatrics, University Hospital of Ioannina, Ioannina, Greece.
Acta Paediatr. 2024 Jun;113(6):1221-1227. doi: 10.1111/apa.17102. Epub 2024 Jan 10.
Newborn thyroid screening tests are carried out during the first days after birth in many parts of the world. The aim of this review was to assess whether additional thyroid function tests of neonates born to mothers with hypothyroidism are necessary to diagnose newborns with congenital hypothyroidism (CH) missed by the usual screening test.
A search in PubMed and Google Scholar databases was conducted for pertinent studies, using relevant keywords. All studies that were published in any language from 1 January 2000 to 30 June 2023 were included. Observational cohort studies were included in the analysis, while case reports and studies not referring to neonates were excluded.
Thirteen studies were identified comprising more than 4400 infants with CH. Studies with the larger study populations recommended against additional testing in healthy infants of hypothyroid mothers. Similar were the results of some smaller retrospective studies. Few studies identified in total 16 infants with CH that were missed on neonatal screening without, though, a definite causative link between the mother's and the infant's thyroid dysfunction.
Based on available data, additional thyroid function tests seem redundant in identifying undiagnosed cases of CH. Larger studies are needed to reach a definite conclusion.
在世界许多地方,新生儿甲状腺筛查试验在出生后的头几天进行。本综述的目的是评估对于来自甲状腺功能减退症母亲的新生儿,是否有必要进行额外的甲状腺功能检查,以诊断通常筛查试验漏诊的先天性甲状腺功能减退症(CH)。
在 PubMed 和 Google Scholar 数据库中使用相关关键词进行了相关研究的检索。纳入了 2000 年 1 月 1 日至 2023 年 6 月 30 日发表的所有语言的研究。分析中纳入了观察性队列研究,排除了病例报告和未涉及新生儿的研究。
确定了 13 项研究,共纳入了超过 4400 例 CH 婴儿。研究表明,对于来自甲状腺功能减退症母亲的健康婴儿,额外的检测似乎是多余的。一些较小的回顾性研究也得出了类似的结果。总共只有少数研究发现了 16 例未通过新生儿筛查的 CH 婴儿,但无法确定母亲和婴儿甲状腺功能障碍之间的明确因果关系。
根据现有数据,额外的甲状腺功能检查似乎对于识别未诊断的 CH 病例是多余的。需要更大规模的研究来得出明确的结论。