Braga Nathalia Teixeira Palla, Alves Debora Patrícia da Silva Sousa, Colosimo Enrico Antônio, Dias Vera Maria Alves, Januário José Nélio, Silva Ivani Novato
Pediatric Endocrinology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Brazil.
Pediatric Endocrinology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Brazil.
J Pediatr (Rio J). 2025 May-Jun;101(3):430-437. doi: 10.1016/j.jped.2024.12.007. Epub 2025 Mar 18.
The objective of this study was to determine the incidence of congenital hypothyroidism (CH) in Minas Gerais, Brazil, and evaluate the development of the Minas Gerais Neonatal Screening Program (PTN-MG) over the past 30 years.
This was a retrospective longitudinal cohort study since the implementation of neonatal screening for CH, in 1994. Bloodspots on filter paper are collected, between the third and fifth day of life, at primary healthcare units, with a TSH threshold of 10 mIU/L. The identification of an abnormal result triggers an active search for the child to confirm the diagnosis. The incidence of CH and its variation over the years, the percentage of permanent cases, and the age at sample collection and treatment initiation were analyzed.
The incidence of CH was 1:3,298 live births among 6,864,719 newborns screened, with no trend of change over the years (p = 0.08). The median age at sample collection decreased from 11 to 5 days (p < 0.01) and at treatment initiation from 88 to 16 days (p < 0.01). Among the confirmed patients, 77 % had permanent CH, thyroid dysgenesis accounted for 43.6 % of cases, gland-in-situ for 56.3 %.
The incidence of CH has remained stable in Minas Gerais over the past 28 years. The PTN-MG is a public health program with an active monitoring and control sector that has shown significant improvements in its indicators since its implementation. The experience of the program has shown that rigorous monitoring and follow-up of infants have been an essential strategy for achieving satisfactory results.
本研究的目的是确定巴西米纳斯吉拉斯州先天性甲状腺功能减退症（CH）的发病率，并评估米纳斯吉拉斯州新生儿筛查项目（PTN-MG）在过去30年中的发展情况。
这是一项回顾性纵向队列研究，自1994年实施CH新生儿筛查以来。在生命的第三天至第五天，在基层医疗单位采集滤纸血斑，促甲状腺激素（TSH）阈值为10 mIU/L。异常结果的识别会促使积极寻找患儿以确诊。分析了CH的发病率及其多年来的变化、永久性病例的百分比以及样本采集和开始治疗的年龄。
在6,864,719名接受筛查的新生儿中，CH的发病率为1:3,298活产，多年来无变化趋势（p = 0.08）。样本采集的中位年龄从11天降至5天（p < 0.01），开始治疗的中位年龄从88天降至16天（p < 0.01）。在确诊患者中，77%患有永久性CH，甲状腺发育不全占病例的43.6%，甲状腺原位占56.3%。
在过去28年中，米纳斯吉拉斯州CH的发病率一直保持稳定。PTN-MG是一个拥有积极监测和控制部门的公共卫生项目，自实施以来其指标有显著改善。该项目的经验表明，对婴儿进行严格的监测和随访是取得满意结果的关键策略。
