Document Detail

Repeat testing for congenital hypothyroidism in preterm infants is unnecessary with an appropriate thyroid stimulating hormone threshold.
MedLine Citation:
PMID:  18252816     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Revised UK neonatal screening guidelines recommend that a second blood sample for assay of thyroid stimulating hormone (TSH) be taken when preterm infants reach a postmenstrual age of 36 weeks. OBJECTIVE: To examine the results of a regional screening programme to see whether a rise in TSH concentration was observed in some preterm infants between the first sample taken around 5 days after delivery and the second sample taken at around 36 weeks. METHODS: Whole-blood TSH concentrations in preterm infants born over a 2-year period (April 2005 to March 2007) were assessed, and the number of infants in whom there was a fall or rise to values below or above the local screening threshold (6 mU/l) was determined. RESULTS: Baseline TSH samples were obtained from 2238 preterm infants (median gestational age 32 weeks, range 21-35) with second samples obtained from 2039 (median gestational 32 weeks, range 23-35). In 19 infants, TSH concentrations fell from above to below the screening threshold, and in five infants values rose from below the screening threshold to 6-10 mU/l. However, TSH concentrations fell to <6 mU/l on a further blood spot in four of these infants, and the remaining infant had a serum TSH of 6.8 mU/l. Three infants had raised TSH concentrations on both occasions with unequivocal hypothyroidism (serum TSH >80 mU/l). The initial TSH concentration in one of these infants was 6-10 mU/l. CONCLUSIONS: No infant with a normal TSH concentration on first sampling had a TSH concentration that rose above 10 mU/l on second sampling, and no infants with a normal TSH concentration on first screening are receiving long-term thyroxine treatment. This study suggests that a second sample may not be necessary with a screening threshold of 6 mU/l.
M Korada; M S Pearce; M P Ward Platt; E Avis; S Turner; H Wastell; T Cheetham
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Publication Detail:
Type:  Journal Article     Date:  2008-02-05
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  93     ISSN:  1468-2052     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-23     Completed Date:  2008-09-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F286-8     Citation Subset:  AIM; IM    
School of Clinical Medical Sciences (Child Health), Sir James Spence Institute, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.
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MeSH Terms
Congenital Hypothyroidism / diagnosis*
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / diagnosis*
Neonatal Screening / methods*
Reference Values
Thyroid Function Tests / methods
Thyrotropin / blood*
Reg. No./Substance:

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