There 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. This 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. The 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. Fars 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.

/pdf/prevalence-and-predictive-factors-of-transient-and-permanent-1a24szf6hg.pdf

Prevalence and predictive factors of transient and permanent congenital hypothyroidism in Fars province, Iran.

Maternal exposure to air pollution during pregnancy is associated with adverse outcomes in the offspring, but limited studies focused on the impacts of gaseous air pollution on newborn congenital hypothyroidism (CH). Therefore, a national data-based analysis was conducted to explore the association between maternal exposure to gaseous air pollution and the incidence of CH in China. Annual average exposure levels of SO2, NO2, CO, and O3 from January 1, 2014, to December 30, 2014, were acquired from the Chinese Air Quality Online Monitoring and Analysis Platform. The annual incidence of newborn CH from October 1, 2014, to September 30, 2015, was collected from the Chinese Maternal and Child Health Surveillance Network. Temperature and toxic metal in wastewater in 2014 were also collected as covariates. Maternal exposure to O3 and NO2 in 1 μg/m3 level increment was positively associated with newborn CH, with an OR of 1.055 (95% CI 1.011, 1.102) and 1.097 (95% CI 1.019, 1.182) after adjusting for covariates completely. Compared with the lowest level of O3, maternal exposure to the 4th quartile of O3 was positively associated with newborn CH (OR 1.393, 95% CI 1.081, 1.794) after adjusting for covariates completely. And the 3rd and 4th quartiles of NO2 were associated positively with CH (OR 1.576, 95% CI 1.025, 2.424, and OR 1.553, 95% CI 0.999, 2.414, respectively) compared with the lowest level of NO2. By fitting the ROC curve, 93.688 μg/m3 in O3 might be used as cutoff to predict the incidence of newborn CH in China.

/pdf/maternal-exposure-to-o-3-and-no-2-may-increase-the-risk-of-5gaur79742.pdf

Maternal exposure to O 3 and NO 2 may increase the risk of newborn congenital hypothyroidism: a national data-based analysis in China.

The objective of this study was to determine the association between birthweight and risk of thyroid and autoimmune conditions in a large sample of postmenopausal women. Baseline data from the Women's Health Initiative (n = 80,806) were used to examine the associations between birthweight category (<6 lbs., 6-7 lbs. 15 oz, 8-9 lbs. 15 oz, and ≥10 lbs.) and prevalent thyroid (underactive and overactive thyroid and goiter) and autoimmune (lupus, rheumatoid arthritis (RA), multiple sclerosis, ulcerative colitis/Crohn's disease) conditions. Follow-up questionnaire data were used to examine the associations between birthweight and incident underactive and overactive thyroid, lupus, and RA. Logistic and Cox proportional hazards regression models were used to estimate crude and adjusted odds (OR) and hazards ratios (HR), respectively. Overall, women born weighing ≥10 lbs. had an increased risk for underactive thyroid [OR 1.14 (95% CI 1.02, 1.28)] and incident lupus [HR 1.51 (95% CI 1.12, 2.03)] and a decreased risk for overactive thyroid [OR 0.67 (95% CI 0.50, 0.92)] compared to women born weighing 6-7.99 lbs., after adjustment for adult BMI, demographic variables, and lifestyle factors. Further, women born weighing <6 lbs. were at increased risk for underactive thyroid [OR 1.13 (95% CI 1.04, 1.22)]. Birthweight was not associated with other thyroid or autoimmune disorders. High birthweight was associated with later-life thyroid and autoimmune conditions while low birthweight was associated with underactive thyroid. Preconception and prenatal interventions aimed at reducing the risk of both high and low birthweights may reduce the burden of later-life thyroid and autoimmune conditions.

Birthweight and subsequent risk for thyroid and autoimmune conditions in postmenopausal women.

Thyroid hormones (TH) regulate growth, nervous system myelination, metabolism, and physiologic functions in nearly every organ system. Congenital hypothyroidism (CH) is one of the most common endocrinopathies in children and has potentially devastating neurologic and developmental consequences. The etiology and clinical manifestations of hypothyroidism in children differ from adults. And hence, pediatric medical care requires a detailed understanding of thyroid function and dysfunction in children. The perinatal risk factors include female sex, preterm birth, low birth weight, postmature birth, additional birth abnormalities, and being delivered in multiple births. In countries where newborn screening is practiced, CH is detected after birth through screening tests. It aids in determining the underlying cause, though some patients may be able to start treatment without these tests. Early detection and treatment prevent irreversible and permanent nervous system damage. Thus, in addition to exploring the development of CH, this article has also covered the epidemiological data, clinical aspects, and management stemming from pediatric hypothyroidism.

/pdf/congenital-anomalies-in-infant-with-congenital-m9kfkqes.pdf

Congenital Anomalies in Infant With Congenital Hypothyroidism: A Review of Pathogenesis, Diagnostic Options, and Management Protocols

Utility of Repeat Testing for Congenital Hypothyroidism in Very Low Birthweight Infants.

Perinatal risk factors for congenital hypothyroidism: A retrospective cohort study performed at a tertiary hospital in China.

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Perinatal risk factors for congenital hypothyroidism: A retrospective cohort study performed at a tertiary hospital in China.