Preprint Article Version 1 This version not peer reviewed

Impact of Lower Screening TSH Cutoff Level on the Increasing Incidence of Congenital Hypothyroidism

Version 1 : Received: 7 February 2017 / Approved: 8 February 2017 / Online: 8 February 2017 (10:54:10 CET)

A peer-reviewed article of this Preprint also exists.

Anastasovska, V.; Kocova, M. Impact of Lower Screening TSH Cutoff Level on the Increasing Prevalence of Congenital Hypothyroidism. Int. J. Neonatal Screen. 2017, 3, 007. Anastasovska, V.; Kocova, M. Impact of Lower Screening TSH Cutoff Level on the Increasing Prevalence of Congenital Hypothyroidism. Int. J. Neonatal Screen. 2017, 3, 007.

Journal reference: Int. J. Neonatal Screen. 2017, 3, 007
DOI: 10.3390/ijns3020007

Abstract

Lower cutoff levels in screening programs have led to an increase in the proportion of detected cases with transient hypothyroidism, leading to increase of the overall incidence of primary congenital hypothyroidism (CH) in several countries. We have performed retrospective evaluation on the data from 251,008 (96.72%) neonates screened for thyroid-stimulating hormone (TSH) level in dried blood spot specimens taken 48 hours after birth, between 2002 and 2015, using DELFIA method. A TSH value of 15 mIU/L was used as the cutoff point until 2010 and 10 mIU/L thereafter. Primary CH was detected in 127 newborns (1/1976) of which 81.1% had permanent and 18.9% had transient CH. The incidence of primary CH was increased from 1/2489 until to 2010 to 1/1585 thereafter (p=0.131). However, the incidence of permanent CH was slightly increased (p=0.922), while the transient CH incidence had 8-fold increasing after lowering the TSH cutoff level (p<0.001). In cases with permanent CH, we observed lower frequency for thyroid dysgenesis (82.7 vs. 66.7%) and higher frequency for normal in-situ thyroid gland (17.3 vs. 33.3%), for the period with reduced TSH cutoff value. Our findings support the impact of lower TSH cutoff on the increasing incidence of congenital hypothyroidism.

Subject Areas

congenital hypothyroidism; incidence; neonatal screening; thyroid-stimulating hormone; cutoff level

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