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The value of serial newborn screening for congenital hypothyroidism using thyroxine (T4) in the neonatal intensive care unit

Journal of Perinatology volume 39, pages 1065–1071 (2019)Cite this article

Subjects

Abstract

Objective

To evaluate the role of serial newborn screening of congenital hypothyroidism using thyroxine (T4) in the neonatal intensive care unit (NICU).

Subjects

Newborn screen results were reviewed from a single academic NICU during 2007–2016 (n = 6100). Thyroid function levels were reviewed in patients treated for hypothyroidism during that period. Duration of treatment was followed after discharge.

Results

Overall incidence of treated hypothyroidism was 1:103 with increasing incidence inversely related to birth weight. Among treated infants (n = 59), initial newborn screen demonstrated sensitivity and specificity of 74.1% and 84.9%, respectively; second screen demonstrated rates of 85.7% and 76.1%, respectively. Based on follow-up data, prevalence of permanent congenital hypothyroidism in our NICU population was 1:870 (n = 7); two patients would have been missed with a single screen.

Conclusion

Abnormal T4 on newborn screening is common for preterm neonates. Higher rates of permanent congenital hypothyroidism highlight the need for screening beyond the newborn screen.

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Acknowledgements

We would like to thank our collaborators at the Texas Department State Health Services for their assistance.

Author information

Authors and Affiliations

  1. Division of Neonatal-Perinatal Medicine, Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA

    Tina O. Findley & Amir Khan

  2. Division of Endocrinology, Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA

    Avni Shah

  3. Division of Nephrology, Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA

    Cynthia Bell

Authors
  1. Tina O. Findley
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  2. Avni Shah
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  4. Amir Khan
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Contributions

TF designed the study, drafted the project proposal, coordinated with IRB, collected data, drafted and approved final paper as submitted. AS was involved in design of the study, collected data, and drafted and approved final paper as submitted. CB performed data analysis, drafted and approved the final paper as submitted. AK was involved in designing of the study, reviewed and approved final paper as submitted.

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Correspondence to Tina O. Findley.

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Findley, T.O., Shah, A., Bell, C. et al. The value of serial newborn screening for congenital hypothyroidism using thyroxine (T4) in the neonatal intensive care unit. J Perinatol 39, 1065–1071 (2019). https://doi.org/10.1038/s41372-019-0400-3

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