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- W2029014692 abstract "To the Editor:We read with interest the article by Oakley et al1Oakley GA Muir T Ray M Girdwood RWA Kennedy R Donaldson MDC. Increased incidence of congenital malformations in children with transient thyroid-stimulating hormone elevation on neonatal screening.J Pediatr. 1998; 132: 726-730Abstract Full Text Full Text PDF PubMed Scopus (58) Google Scholar reporting that transient TSH elevation on the fourth day of life is associated with a high incidence of congenital malformations, prematurity, and ìsickness.î A combination of increased perinatal stress and iodine exposure in ill babies may be factors. Their recommendation to reevaluate the thyroid status of those infants at a later date is appropriate indeed.We would like to share our experience with a neonatal screening program for congenital hypothyroidism in which thyroxine and TSH are measured from cord blood (therefore excluding iodine exposure on thyroid function).2Narchi H Kulaylat NA. Congenital hypothyroidism screening program: a five year experience.Ann Saudi Med. 1996; 16: 47-49PubMed Google Scholar In screening 15,000 neonates, 3 cases of primary hypothyroidism were diagnosed (prevalence 1 in 5061 births). Hypothyroxinemia was diagnosed in another 5 who died in the immediate neonatal period; all had congenital malformations, but only 3 had elevated cord TSH (26, 87, and 468 mU/mL). Because all died in the immediate neonatal period, they cannot be classified with certainty as having had transient or permanent hypothyroidism. No postmortem examinations were performed.Although our data support Oakleyís findings that TSH levels are elevated in some neonates with congenital anomalies, this is not invariably the case. Cord blood hypothyroxinemia (regardless of TSH levels) is also associated with congenital anomalies. TSH and T4 were measured before any iodine exposure because none of the affected infants in our series was delivered by cesarean section. Cord blood thyroxine measurement eliminates the potential effect of iodine on the TSH level measured after day 4. To the Editor:We read with interest the article by Oakley et al1Oakley GA Muir T Ray M Girdwood RWA Kennedy R Donaldson MDC. Increased incidence of congenital malformations in children with transient thyroid-stimulating hormone elevation on neonatal screening.J Pediatr. 1998; 132: 726-730Abstract Full Text Full Text PDF PubMed Scopus (58) Google Scholar reporting that transient TSH elevation on the fourth day of life is associated with a high incidence of congenital malformations, prematurity, and ìsickness.î A combination of increased perinatal stress and iodine exposure in ill babies may be factors. Their recommendation to reevaluate the thyroid status of those infants at a later date is appropriate indeed.We would like to share our experience with a neonatal screening program for congenital hypothyroidism in which thyroxine and TSH are measured from cord blood (therefore excluding iodine exposure on thyroid function).2Narchi H Kulaylat NA. Congenital hypothyroidism screening program: a five year experience.Ann Saudi Med. 1996; 16: 47-49PubMed Google Scholar In screening 15,000 neonates, 3 cases of primary hypothyroidism were diagnosed (prevalence 1 in 5061 births). Hypothyroxinemia was diagnosed in another 5 who died in the immediate neonatal period; all had congenital malformations, but only 3 had elevated cord TSH (26, 87, and 468 mU/mL). Because all died in the immediate neonatal period, they cannot be classified with certainty as having had transient or permanent hypothyroidism. No postmortem examinations were performed.Although our data support Oakleyís findings that TSH levels are elevated in some neonates with congenital anomalies, this is not invariably the case. Cord blood hypothyroxinemia (regardless of TSH levels) is also associated with congenital anomalies. TSH and T4 were measured before any iodine exposure because none of the affected infants in our series was delivered by cesarean section. Cord blood thyroxine measurement eliminates the potential effect of iodine on the TSH level measured after day 4. We read with interest the article by Oakley et al1Oakley GA Muir T Ray M Girdwood RWA Kennedy R Donaldson MDC. Increased incidence of congenital malformations in children with transient thyroid-stimulating hormone elevation on neonatal screening.J Pediatr. 1998; 132: 726-730Abstract Full Text Full Text PDF PubMed Scopus (58) Google Scholar reporting that transient TSH elevation on the fourth day of life is associated with a high incidence of congenital malformations, prematurity, and ìsickness.î A combination of increased perinatal stress and iodine exposure in ill babies may be factors. Their recommendation to reevaluate the thyroid status of those infants at a later date is appropriate indeed. We would like to share our experience with a neonatal screening program for congenital hypothyroidism in which thyroxine and TSH are measured from cord blood (therefore excluding iodine exposure on thyroid function).2Narchi H Kulaylat NA. Congenital hypothyroidism screening program: a five year experience.Ann Saudi Med. 1996; 16: 47-49PubMed Google Scholar In screening 15,000 neonates, 3 cases of primary hypothyroidism were diagnosed (prevalence 1 in 5061 births). Hypothyroxinemia was diagnosed in another 5 who died in the immediate neonatal period; all had congenital malformations, but only 3 had elevated cord TSH (26, 87, and 468 mU/mL). Because all died in the immediate neonatal period, they cannot be classified with certainty as having had transient or permanent hypothyroidism. No postmortem examinations were performed. Although our data support Oakleyís findings that TSH levels are elevated in some neonates with congenital anomalies, this is not invariably the case. Cord blood hypothyroxinemia (regardless of TSH levels) is also associated with congenital anomalies. TSH and T4 were measured before any iodine exposure because none of the affected infants in our series was delivered by cesarean section. Cord blood thyroxine measurement eliminates the potential effect of iodine on the TSH level measured after day 4." @default.
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- W2029014692 title "Increased TSH levels in neonates with congenital malformations" @default.
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