Abstract
IntroductionThere is no data on the number as well as the prevalence of congenital hypothyroidism (CH) in the Fars province. Hence, we designed this study to analyze the latest data and the possible predictive factors on transient and permanent CH in this province.MethodThis cross sectional study is based on the Fars province screening data from 2013 to 2016. A total of 294,214 newborns were screened with 938 confirmed cases of CH, which were included in this study. After recall and completion of the missing data, follow-up data for 642 CH cases with thyroid stimulating hormone (TSH) concentrations and levothyroxine doses for ten outpatient visits and final transient vs. permanent CH diagnosis were included.ResultsThe incidence rate was 1:313.66, and out of the 642 CH cases, 66.04 % had permanent CH, while 33.96 % had transient CH. TSH level trend during the outpatient visits were not statistically different between the two groups (P = 0.312). A cutoff point of > 2.25 levothyroxine µg/kg (sensitivity: 76.11 %, specificity: 58.52 %) at the third year and a TSH concentration of > 43.35 mIU/L at the venous sampling (initial TSH) (sensitivity: 31.66 %, specificity: 90.32 %) were the predictive factors for permanent CH.ConclusionFars province has one of the highest incidence rate of CH in Iran. Levothyroxine dose at the 3rd year and the 1st venous TSH sample are the predictive factors for permanent CH in the Iranian population; however, TSH concentrations during follow ups are unreliable predictors.
Highlights
There is no data on the number as well as the prevalence of congenital hypothyroidism (CH) in the Fars province
Several studies showed that dyshormonogenesis, which is mainly caused by autosomal recessive inheritance, has higher prevalence rate amongst the CH patients in Iran [11, 18, 29]
The trend in reduction of thyroid stimulating hormone (TSH) concentration in the span of ten outpatient visits was not statistically different between the transient vs. permanent CH; we found TSH serum concentration level to be generally higher throughout all visits in permanent CH cases
Summary
There is no data on the number as well as the prevalence of congenital hypothyroidism (CH) in the Fars province. A prompt thyroid hormone replacement in newborns with Levothyroxin will lead to normal neurologic growth [7]. A cohort study reported the prevalence rates of 1 per 4,094 births in the USA in 1987, which increased to 1 per 2,372 births in 2002 [9]. Reports from Iran indicate 1 per 914 live births in Tehran to 1 per 357 live births in Isfahan [10, 11]. These reports reveal much higher rate than the 1 in 4000 in North America, Europe and Australia [12, 13]
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