Evaluation of thyroid function in a sample of newborns through different modes of delivery
Background and objective: Congenital hypothyroidism is the most common preventable cause of mental retardation detected during early childhood. Its early diagnosis is crucial for a better outcome. Many factors are contributed to this problem including maternal, fetal and others. This study aimed to assess thyroid hormone status in relation to certain obstetrical especially mode of delivery and neonatal factors
Methods: A descriptive cross-sectional study conducted in postnatal care and delivery room (operative and vaginal) of Maternity teaching hospital in Erbil city. Ninety-two babies were included and subdivided into three groups according to their route of delivery. A thyroid stimulating hormone cut off value of 10 was selected as the upper normal level for the purpose of the study.
Results: A significant proportion of babies with cord thyroid stimulating hormone concentration more than 10 mIU/L (25 out of 92) were noticed, and this is near to many previous studies used the same cut off value. Mean of This hormone is relatively increased among newborns of the elective cesarean section while maternal total triiodothyronine and total thyroxine were higher within the elective group. Prenatal evidence of placental calcification and first born babies were associated with higher thyroid stimulating hormone levels.
Conclusion: Emergency cesarean section is less likely to be associated with elevated cord blood thyroid stimulating hormone level compared to other routes of delivery/but this is not confirmatory and recall test is recommended to exclude hypothyroidism.
Sangeeta N, Kamala L, Karki P, Basar G, Kumar YI, Singh LR, et al. Assessment of umbilical cord TSH in term neonates in Manipur. IOSR-JDMS 2013; 9(1):14–7.
Nasheiti NA. Childhood hypothyroidism in Iraq: A retrospective study. Int J Endocrinol Metab 2005; 3:136–9.
Bernal J. Thyroid hormones and brain development. Vitam Horm 2005; 71:95–122.
Zoeller TR, Dowling AL, Herzig CT, Iannacone EA, Gauger KJ, Bansal R. Thyroid hormone, brain development, and the environment. Environ Health Perspect 2002;110(Suppl 3):355–61.
John J, Abraham A, Sahu S. Umbilical cord blood TSH: a predictor of congenital hypothyroidism. Indian J Physiol Pharmacol 2013; 57(4):452–3.
Sanghvi U, Diwakar KK. Universal newborn screening for congenital hypothyroidism. Ind Pediatr 2008; 45:331–2.
Manglik AK, Chatterjee N, Ghosh G. Umbilical cord blood TSH levels in term neonates: A screening tool for congenital hypothyroidism. Indian Pediatr 2005; 42: 1029–32.
Ugege MO, Airede KI, Jiya NM. Thyroid function profile in cord blood and postnatal changes at 24 and 72hours in healthy term Nigerian neonates. Niger J Paed 2014; 41(3):209–14.
Fuse Y, Wakae E, Nemoto Y, Uga N, Tanaka M, Maeda M, et al. Influence of perinatal factors and sampling methods on TSH and thyroid hormone levels in cord blood. Endocrinol Jpn 1991; 38(3):297–302.
Rose SR, Brown RS, Wilkins L. Update of Newborn screening and therapy for congenital hypothyroidism. Pediatrics 2006; 117: 2290–303.
Shi LX, Ma QL, Zhang JX. Influence of perinatal factors and sampling methods on thyroid stimulating hormone and thyroid hormone levels in cord blood. Zhonghua Fu Chan KeZaZhi 1994; 29:714–6.
Tehrani FR, Aghaee M, Asefzadeh S. The comparison of thyroid function tests in cord blood following cesarean section or vaginal delivery. Int J Endocrinol Metab 2003; 1:22–6.
Devi AR, Naushad SM. Newborn screening in India. Indian Pediatr 2004; 71:157–60.
Kaur G, Srivastav J, Jain S, Chawla D, Chavan BS, Atwal R, et al. Preliminary report on neonatal screening for congenital hypothyroidism, congenital adrenal hyperplasia and glucose- 6-phosphate dehydrogenase deficiency: A Chandigarh experience. Indian J Pediatr 2010; 77:969–73.
Agrawal K. Levels of T4 and TSH in mothers and newborns. Health Renaissance 2013; 11(1):6–10.
Hyman SJ, Novoa Y, Holzman I. Perinatal endocrinology: Common endocrine disorders in the sick and premature newborn. Pediatr Clin North Am 2011; 58(5):1083–98.
Ammash SI, Aldoree F, Sulaiman TI, Al-Jumaily A, Mahmood. Pilot study on neonatal screening for congenital hypothyroidism in Iraq. Fac Med Baghdad 2008; 50(4):416–9.
Eltom A, Eltom M, Idris M, Gebre-Medhin M. Thyroid function in the newborn in relation to maternal thyroid status during labour in a mild iodine deficiency endemic area in Sudan. Clin Endocrinol (Oxf) 2001; 55:485–90.
Oken E, Braverman LE, Platek D, Mitchell ML, Lee SL, Pearce EN. Neonatal thyroxine, maternal thyroid function, and child cognition. J Clin Endocrinol Metab 2009; 94(2):497–503.
Herbstman J, Apelberg BJ, Witter FR, Panny S, Goldman LR. Maternal, infant, and delivery factors associated with neonatal thyroid hormone status. Thyroid 2008; 18(1):67–76.
Pereira DN, Procianoy RS. Effect of perinatal asphyxia on thyroid hormones. J Pediatr (Rio J) 2001; 77(3):175–8.
Gupta A, Srivastava S, Bhatnagar A. Cord blood thyroid stimulating hormone level - interpretation in light of perinatal factors. Indian Pediatr 2014; 51(1):32–6.
Zoeller RT, Rovet J. Timing of thyroid hormone action in the developing brain: clinical observations and experimental findings. J Neuroendocrinol 2004; 16:809–18.
Joseph R, Aw TC, Tan KL. Free thyroxine as a supplement to thyrotropin in cord screening for hypothyroidism. Ann Acad Med 1993; 22(4):549–52.
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