Abstract
SummaryBackgroundIodine deficiency is associated with goiter and impaired brain function leading to cretinism. An increased frequency of thyroid-stimulating hormone (TSH) measurements above 5 mlU/L on newborn screening points toward an impaired iodine status of the population.MethodsA 13-year retrospective analysis was performed in 228,266 newborns participating in the national thyroid newborn screening program. The TSH concentration was measured in dry blood spots collected by heel stick on filter paper, 48 hours after birth, using fluoroimmunometric DELFIA method.ResultsOut of 236,378 live-born infants, 228,266 (96.6%) have been screened for TSH, of which 198,213 (86.8%) were retrospectively evaluated for TSH levels above 5 mlU/L. Neonates with congenital hypothyroidism, prematurity, and low birth weight were excluded from the evaluation, as well as the inadequately sampled neonates (13.2%). A national prevalence of 3.08% newborns (n=6,105) with TSH > 5 mIU/L was found. Higher percentages were noted in two regions of the country, indicating possible mild iodine deficiency in these regions and shifting the overall average to above 3%.ConclusionsOur results indicate overall iodine sufficiency in the Macedonian population. Additional assessment of the iodine intake in the regions with suspected mild iodine deficiency is needed to prevent suboptimal cognitive and psychomotor outcomes.
Highlights
More than 1.9 billion people worldwide, including 285 million children, have an inadequate iodine intake [1]
Iodine deficiency is associated with goiter and impaired brain function leading to cretinism
The thyroid-stimulating hormone (TSH) concentration was measured in dry blood spots collected by heel stick on filter paper, 48 hours after birth, using fluoroimmunometric DELFIA method
Summary
More than 1.9 billion people worldwide, including 285 million children, have an inadequate iodine intake [1]. Iodine is necessary for the production of thyroid hormones which are essential for normal brain development, especially for the fetus and newborn who are vulnerable to iodine deficiency [2]. Neonatal thyroid-stimulating hormone (TSH) whole blood levels, median urinary iodine excretion, thyroid size and blood thyroglobulin concentration have been recommended as indicators for monitoring iodine status in the population [5,6,7]. Frequency below 3% of TSH concentrations exceeding 5 mIU/L on neonatal thyroid screening indicates iodine sufficiency, frequency between 3 and 19.9% indicates mild iodine deficiency, frequency of 20–39.9% indicates moderate deficiency and frequency above 40% indicates severe iodine deficiency, according to the recommendations of the WHO [4, 6, 7]
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