CONGENITAL HYPOTHYROIDISM (CH) IN ONE UK HEALTH REGION

Abstract

From Nov 1981 to Feb 1987, 289697 infants survived to be eligible for CH screening from one UK health region from which 100 infants were positive by TSH assay. The incidence was 1/3392 for whites and 1/917 for Asians (P=0.0001). The female:male ratio was 3.08:1. There was one transient and one missed case. There was a 9 fold variation in incidence amongst whiles in the 19 health districts within the region. 91/100 CH infants received a technetium scan. 41% were aplastic, 42% ectopic, 3% hypoplastic, and 13% enlarged or normal (EN). The EN group was 4.78 (P=0.02) times commoner amongst consanguinous couples. Thyroid Aplasia was 2.2 Limes commoner in mothers of 25 years or greater (P=0.06) There was a 10% complication rate amongst CH infants. 2% had hyaline membrane disease in isolation, 8% a variety of renal and cardiac anomalies plus 1 trisomy 21. This sub group was screened later (50% screened in last quintile, greater than 19 days, P=0.05) but did not receive treatment later than noncomplicated group (100% of those alive treated by 29 days versus 88% of non complicated group). There was a greatly increased mortality (5.7%) amongst CH infants when compared to the region (P=0.0001).Race, maternal age and consanguinity may determine incidence and scan type of CH. The excess congenital anomalies and mortality are confirmed.