جستجوی مقالات مرتبط با کلیدواژه « congenital hypothyroidism » در نشریات گروه « پزشکی »

 Congenital hypothyroidism (CH) can influence neonates’ neurodevelopment. There are controversies on the cause of infantile hypothyroidism and its relationship with maternal hypothyroidism.

 This study aimed to investigate the relationship between maternal hypothyroidism and the incidence of CH.

 This cross-sectional study was conducted on 712 newborns with hypothyroidism born in Fars province, Iran, between 2018 and 2020, identified through the national screening program for genetic, metabolic, and endocrine congenital diseases recruited by the census sampling method. The information on infants’ files was recorded in a researcher-made checklist. Descriptive data were reported by mean ± SD and No. (%). The independent t-test, chi-square test, Pearson correlation, and Spearman’s rank correlation coefficient were used to evaluate relationships between variables.

 Of 179,448 infants screened, 712 (4 of 1,000 live births) had CH with a mean thyroid stimulating hormone (TSH) level of 22.34+24.8 mlU/L. Of these, 252 infants (35.4%) had a family history of hypothyroidism in the mother (OR = 4.951, P < 0.001). There was a significant relationship between CH and maternal hypothyroidism. Moreover, there was a significant difference in the mean TSH level between hypothyroid infants born to mothers with a history of hypothyroidism (19.10 ± 21.30 mlU/L) and those who had healthy mothers (24.23 ± 26.44 mlU/L, P = 0.027). The prevalence of CH in 2018, 2019, and 2020 were reported to be 0.34%, 0.4%, and 0.45%, respectively.

 Our results showed a significant relationship between maternal hypothyroidism and CH. Considering the importance of the prompt diagnosis of CH, especially in high-risk groups such as infants of hypothyroid mothers, it is recommended to conduct more studies to design more precise guidelines to screen infants who are at risk of CH.

Recent studies have shown an increased incidence of congenital hypothyroidism (CH), especially in the middle‑east region. The exact etiology is unknown; however, it has been related to several factors, the most noticeable being the high prevalence of transient CH (TCH), parental consanguinity, and the history of hypothyroidism in relatives. We sought to determine the impact of hypothyroidism in the relatives of patients with the observed trend.

We included all patients with primary CH detected through the Newborn Screening (NBS) Program from 2007 to 2016. We analyzed the impact of consanguinity relationship, parental and siblings’ thyroid function, second‑degree relatives’ thyroid function, parental educational level, age, and maternal gestational diabetes on the development of permanent CH (PCH) and TCH.

A total of 1447 consecutive eligible patients were recruited during the study period. Of this number, 1171 (81%) were diagnosed with CH: 623 (53.2%) had PCH and 548 (46.8%) had TCH. Six hundred thirty‑three (54.1%) participants were men, and 814 (69.5%) had a history of relatives’ hypothyroidism. Our data analysis revealed a significant difference regarding the male gender, having a history of relatives’ hypothyroidism, and parental hypothyroidism compared to TCH ones (P < 0.05). Patients with a history of relatives’ hypothyroidism had significantly higher PCH than TCH (P < 0.0001). However, consanguineous marriage was not comparable in patients regardless of their history of relatives’ hypothyroidism (P‑value >0.884).

Our findings indicated the role of the history of hypothyroidism in neonates’ relatives in the evolution of the PCH. Meanwhile, consanguineous marriage did not impress the development of PCH and TCH.

Context: 

Hypothyroidism describes an endocrine disorder that occurs when the thyroid gland cannot secrete adequate thyroid hormones. Congenital hypothyroidism refers to a lack of thyroid hormone among newborns.

Evidence Acquisition: 

The ISI Web of Sciences, Scopus, PubMed, and Google Scholar databases were reviewed for relevant articles published from 2000 to 2022.

 Congenital hypothyroidism, occurring in approximately one in 2,000 to one in 4,000 newborns, ranks among the most frequent causes of intellectual disability that can be prevented. The screening of newborns, confirmation assessments, interpretation of thyroid function tests accurately, prompt and therapeutic treatment, and regular follow-up contribute to a very good neurocognitive outcome later in life. Since the timely diagnosis of congenital hypothyroidism is critical in preventing mental retardation, clinicians must be kept abreast of this disorder and educate nursing and medical students regarding accurate interpretations of diagnostic testing and the recognition of associated symptoms. Most newborns with congenital hypothyroidism present no symptoms, even though their TSH or T4 levels are likely to have fluctuated significantly. As a result, congenital hypothyroidism was rarely detected in newborns before the introduction of neonatal screenings.

 We provide an overview of the etiology, epidemiology, manifestation, diagnosis, and treatment of congenital hypothyroidism based on the latest studies.

Congenital hypothyroidism is one of the most common preventable causes of mental retardation. The present study aimed to compare the characteristics of neonates with false-positive congenital hypothyroidism screening test results with affected neonates in Kerman. This cross-sectional study was conducted on neonates called to confirm congenital hypothyroidism from 2016 to 2017. The neonate characteristics (year and season of birth, sex, umbilical hernia, fontanelle conditions, constipation, jaundice, abnormalities, head circumference, height and weight at birth, gestational age, type of delivery, parental consanguinity, history of thyroid disease in the family, childbirth location, history of hospitalization, and place of residence) and maternal characteristics (age, number of deliveries, history of stillbirth, history of illness, and drug use during pregnancy) were extracted from their medical records. The collected data were analyzed with SPSS software (version 20) using the chi-square and independent samples t test. From a total of 985 neonates who had a positive screening test, congenital hypothyroidism was confirmed in only 58 neonates(5.9%), and the other 927 neonates(94.1%) only had a positive screening test. The neonates’ and mothers’ characteristics were not significantly different in the two groups, except for constipation, which had a higher frequency in the neonates with a positive congenital hypothyroidism screening results than in the affected neonates (P = 0.004). In this study, the characteristics of neonates who only had a positive hypothyroidism screening test result were not significantly different from those of the affected neonates. It is recommended that further studies be conducted over a longer period.

Congenital hypothyroidism (CH) is one of the most treatable endocrine disorders in infants and children that can influence the function of many organs in the body. On‑time diagnosis and treatment can prevent the adverse effects of thyroid hormone deficiency on the child’s neurodevelopment. There are many challenges in screening, post‑screening, diagnosis, and managing this disorder. Therefore, this article aimed to mention updated information on this issue. Although there are different approaches for the treatment of hypothyroidism, the authors decided to create a national approach based on the conditions of our country.

 The newborn screening program for diagnosing and treating children with congenital hypothyroidism (CH) in Iran was established in 2004.

 This study aimed to evaluate the national program’s success in maintaining the physical development and anthropometric indexes of children with CH.

 This historical cohort study was carried out in five provinces located in five different geographical regions of Iran. The anthropometric indexes, including weight, height, and head circumference of 240 children diagnosed with transient congenital hypothyroidism (TCH) (n = 131) and permanent congenital hypothyroidism (PCH) (n = 109) were measured and compared with those of 240 healthy children aged six.

 Mean ± standard deviation (SD) of weight, height, and head circumference of children with CH aged six were 20304.8 ± 4457.9 g, 115.6 ± 5.9 cm, and 50.8 ± 1.7 cm, respectively. Mean ± SD of height (116.7 ± 6.1 cm) and head circumference (51.1 ± 1.7 cm) in the control (healthy) group were significantly higher than those of the CH children group (P < 0.05). Mean ± SD weight in the control group (20741.2 ± 4337.3 g) was higher than that in the CH group (20304.8 ± 4457.9 g). However, the difference was not statistically significant (P = 0.3). No significant difference was observed between TCH and PCH children in the subgroup analysis (P > 0.05).

 Although the mean of anthropometric indexes in CH patients was slightly lower than that in healthy children aged six, the difference between the two groups was insignificant. The physical development of children with CH was evaluated as good. Our results suggested that the newborn screening program for identifying and treating children with CH in Iran may have improved the growth outcomes.

Hypothyroidism is known as the most common endocrine disorder. The prevalence of hypothyroidism in the female and male population is 2% and 0.2%, respectively. Maternal hypothyroidism is a defect in the thyroid hormones transition from the mother to the fetus. The present study was conducted to find whether maternal hypothyroidism affects the fertility of the second generation.

In this experimental study, twelve adult female rats weighting 180-220 g were randomly divided into case and control groups. Hypothyroidism was induced by dissolving 0.1 g/L of 6-n-propyl-2-thiouracil in drinking water toward the end of pregnancy and lactation. At the end of the breastfeeding period, the blood samples of female children were collected. Six healthy, mature, female rats were selected and kept until they reached maturity, and were then mated with male rats. After observing the female rats’ delivery, blood samples were collected from their male and female newborns and the healthy rats were selected.

There was a significant difference in the volume and size of ovarian as well as in the number of secondary follicles in comparison with the control group (P=0.025). However, there were no significant changes in the other parameters including the number of primary follicles, the number of Graafian follicles and sperm parameters. There was no significant decrease in the testicular volume and size, number of Leydig cells and seminiferous tubules diameter.

Maternal hypothyroidism has no significant effects on testicular tissue function, and sperm parameters in the second generation, but can significantly reduce the rate of secondary follicles in the second generation female rats.

Congenital hypothyroidism (CH) is the most common curable cause of mental retardation. The aim of this study was to compare the intelligence quotient (IQ) of congenital hypothyroid patients with that of healthy children.
This case-control cross-sectional study was performed on 30 permanent CH children within the age range of 6-12 years referring to the Endocrine Clinic of Imam Reza Hospital, Mashhad, Iran between April 2017-2019. In addition, 32 healthy children of the same age and gender from the family members of the patients were chosen as the control group. The intelligence test was performed using the revised version of the Wechsler Intelligence Scale for Children and the mean verbal, performance, and total IQ were compared between case and control groups.
There was no significant difference between the two groups in terms of age and gender. The mean verbal, performance, and total IQ in the case group were obtained as 104.33±13.30, 93.13±7.42, and 98.03±7.94, respectively. With regard to the healthy group, these mean values were, respectively, estimated at 121.34±16.74, 99.65±11.92, and 110.71±14.15 (the normal range of IQ was 90-109).
Accordingly, the results revealed a significant difference between the two groups in terms of verbal (P=0.000), performance (P=0.013), and total (P=0.000) IQ. Furthermore, a relationship was found between early treatment initiation and higher verbal IQ (r=0.521; P=0.032), as well as between lower thyroid-stimulating hormone and higher performance IQ (r=0.559; P=0.020).
The permanent CH children that had received timely treatment had normal levels of IQ based on the Wechsler Intelligence test. However, it was significantly lower in the CH children than that in healthy children of the same age, gender, and socioeconomic status.

Congenital hypothyroidism is a disease able to cause severe mental retardation and developmental delays. However, timely diagnosis and treatment of infants with this disease could prevent relevant complications. This study aims to investigate the effects of the implementation of the Six Sigma model on reducing the treatment initiation time in infants with congenital hypothyroidism in the population chosen from Samen Health Center in Mashhad.

In this quasi-experimental study, the referral process of infants for congenital hypothyroidism screening and treatment was evaluated for the time period starting from March 20, 2017, to March 19, 2018, using the standard five-phase quality strategy, description, measurement, analysis, improvement and control phase (DMAIC), based on Six Sigma. Data were collected using the sampling form of the national screening program for congenital hypothyroidism. To analyze the data, software including Expert Choice V11, Microsoft Excel 2013, and SPSS 18, were utilized. In addition, a p-value less than 0.05 was considered statistically significant.

The number of infants who entered the intervention process was 4,574, of whom 51.3% (2346 infants) were boys. The mean time to start treatment before the implementation of the model was 21.72±7.72 days, which decreased to 17.41±6.47 days after the implementation of the model (p≤ 0.05). Besides, 81.8% of the patients received treatment during infancy before the intervention, which increased to 94.1% after it. After the implementation of the Six Sigma model, the Sigma level of treatment initiation improved from 2.41 to 3.06.

Six Sigma could be used as an intervention tool for improving indices of health intervention processes.

This study was designed and conducted to investigate the spatial distribution of permanent and temporary congenital hyperthyroidism (PCH and TCH) in Isfahan.

This study was conducted on neonates who were born from March 21, 2006 to March 20, 2011 and had undergone the congenital hypothyroidism (CH) screening program in counties affiliated to the Isfahan University of Medical Sciences. CH was diagnosed in 958 patients who treated with levothyroxine. The incidence rates of permanent and temporary congenital hypothyroidism in Isfahan province were calculated and their distribution was shown on the map. The space maps were drawn using the ArcGIS software version 9.3.

Based on the data obtained from the screening program, the average incidence of congenital hypothyroidism in the province during the period of 2006–2011 was 2.40 infants per 1000 live births (including both PCH and TCH). The most common occurrence was in Ardestan County (10:1000) and the lowest overall incidence was observed in the Fereydounshahr county (1.39:1000). The incidence of PCH in the counties of Ardestan and Golpayegan had the highest rate in all years of study; and the greatest number of TCH cases in the five years were observed in Nain, Natanz, Khansar and Chadegan counties.

Adding the time dimension and performing spatial-temporal analysis is suggested because of the following items: high prevalence of CH in Isfahan province, the important role of this disease in mental retardation and neuropsychiatric disorder, the necessity of conducting future medical researches to find possible factors of CH etiology in Isfahan province, as well as necessity of performing spatial analysis with advanced statistical methods.

Congenital hypothyroidism (CH) is one of the most prevalent preventable causes of mental retardation. Studies show that the incidence rate of CH is very high in Iran. Disease mapping is a tool for visually expressing the frequency, incidence, or relative risk of illness. The present study aimed to model CH counts considering the effects of the neighborhood in towns and perform mapping based on the relative risk.

In this historical cohort study, data of all neonates diagnosed with CH with TSH level ≥5 mIU/L between March 21, 2017, and March 20, 2018, in health centers in Guilan, Iran were used. The number of neonates with CH was zero in most towns of Guilan Province. The Bayesian spatial zero-inflated Poisson (ZIP) regression model was employed to investigate the effect of the town’s neighborhood on the relative risk of CH incidence. Then, the map of the posterior mean of the relative risk for CH incidence was provided. The analysis was performed using OpenBUGS and Arc GIS software programs.

The relative risk of CH incidence was high in the West of Guilan. Moreover, the goodness-of-fit criterion indicated that it is more appropriate to fit the Bayesian spatial ZIP model to these data than the common model.

Considering the high relative risk of CH in the Western towns of Guilan Province, it is better to check important risk factors in this region.

Context:

Congenital hypothyroidism is the most common congenital disorder of the endocrine system, which can lead to preventable mental retardation.

We aimed to evaluate the current status of congenital hypothyroidism information registry systems.

Data Sources:

In this systematic review, the databases Scopus, science direct ProQuest, PubMed, as well as the search engine Google scholar (no restriction on date of publication) up to 2020, were searched. Inclusion criteria were the Articles with the English language that examining information registry systems on congenital hypothyroidism. Articles whose full texts were not accessible, case reports, and letters to the editor had to be excluded. In order to selection of relevant studies, the retrieved articles were accordingly screened based on the inclusion and exclusion criteria.

Study Selection:

in this systematic review 290 papers identified. A total of 254 articles were screened, of which 17 qualified articles were selected.

Data Extraction:

Two authors used the data extraction form to independently extract relevant data from included studies. Disagreements between authors were reconciled through discussion and consensus.

The results of this study showed that the main goal of nearly half (50%) of the information registry systems for congenital hypothyroidism is to evaluate the efficiency and effectiveness of the screening program. Other information registry systems for congenital hypothyroidism work with the aim of examining the epidemiology of disease in 4 studies (23.6%), monitoring iodine deficiency 3 studies (18%), surveillance disease 1 study (6%) and describing the clinical and familial features of the patient 1 study (6%).

Few studies have been done on the development of an information registry systems, and most studies have focused on the use of information systems in this field. Further Comprehensive reviews are recommended to investigate the infrastructure to commission national registry and world network to record information units on congenital hypothyroidism.

Congenital hypothyroidism (CH) is one of the most common endocrine diseases and one of the major causes of mental retardation in children. So we aimed to evaluate the developmental outcome of children with CH.

This case-control study was performed on two 3-6-year-old groups of 100 patients. The case group was children with CH, referred to Endocrine Clinic of Amirkola Children's Hospital (2011-2017) and the control group was healthy children and normal from other states. The Denver developmental screening test-II (DDST_II) was used to assess the developmental factors and disorders in four areas of gross motor, fine motor, personalsocial and language. Data were analyzed by SPSS 21 using descriptive statistics, t-test and chi-square, and a p<0.05 was considered significant.

The mean age of 200 children in the case and control groups was 54.62±15.72 and 59.68±15.64 months, respectively. In the case group, 45% and 55% of them had transient and permanent CH, respectively. All four criteria of DDST_II in the control group as well as gross motor in the case group were normal, but fine motor, personal-social and language were reported normal in 94, 95 and 93% of the case group, respectively. All subjects with abnormal DDST_II, had a negative neonatal screening tests.

The results obtained from DDST_II indicated that 6% of children with CH had an abnormal development, all who had an onset of medical treatment over 30 days, which makes it important to screen the neonatal thyroid disease and diagnose this disease timely

Congenital hypothyroidism (CH) refers to a condition in which there is a low level of thyroid hormone in an infant’s blood. It can result in serious problems in physical and mental development of patients. This study aimed to compare growth indices in patients with and without CH.

Historical cohort study, 96 patients with CH in different counties of Kurdistan province were considered as exposed cases. The non-exposed group included children of the same age, sex and geographical area as much as possible. Independent t-test was used to compare growth indices in the two groups. Moreover, repeated measurement was used to compare the two groups in terms of trend of changes in growth.

There was a significant difference between the two groups of neonates in terms of weight and head circumference measured at third and ninth months of ages (p<0.05) respectively. Moreover, no statistically significant difference was observed between the two groups in terms of the trend of changes in growth percentiles (head circumference, height, and weight) (p>0.05).

The quality of care provided for CH patients in Kurdistan province is at a desirable level.

Congenital hypothyroidism is a common inborn endocrine disorder. Asymptomatic presentation in majority of cases mean that its diagnosis may be missed especially in settings where newborn screening is absent. We present a case of delayed diagnosis of congenital hypothyroidism and emphasize on need for high level of suspicion to aid prompt diagnosis and treatment. Our case is a 3 year, 4 months old male, who was first seen at 5 months of age on account of poor growth. He passed meconium after day four of life, developed jaundice in first week of life, and slept a lot in neonatal period. He had coarse faces, protruding tongue, widened anterior fontanelle and herniation of umbilicus. He was started on oral levothyroxine 50 microgram daily. In resources limited settings where universal newborn screening is absent, healthcare workers should have a high level of suspicion in picking up the early signs of the condition.