DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20160005

Thyroid function determinants in cord blood of Nigerian neonates

Rebecca M. Gali, Iya E. Bassey, Alphonsus E. Udoh, Chinyere A. O. Usoro, Calvin M. Chama, Uwem O. Akpan

Abstract


Background: Congenital hypothyroidism is one of the most prevalent endocrine disorders in the newborn; early diagnosis and treatment have resulted in normal growth and development in nearly all cases. Data on congenital hypothyroidism in Nigeria is limited, hence, this study aims at establishing the baseline values and prevalence of congenital hypothyroidism as a prelude to a screening centre in our locality.

Methods: Cord blood samples were consecutively obtained from two hundred and eighty nine neonates born in the Delivery ward of the University of Maiduguri Teaching Hospital (UMTH). 152 (52.8%) of the neonates were males and 137 (47.2%) were females. Nineteen were preterm and 270 were full term. Triiodothyronine (T3), Thyroxine (T4) and Thyroid-stimulating hormone (TSH) were analyzed using ELISA kits. Data was analyzed using student “t” test and Pearson correlation coefficient. The difference was considered statistically significant at p < 0.05.

Results: The mean T3, T4 and TSH, in preterm compared with full term neonates were similar (p>0.05). Triiodothyronine (T3) was undetectable in 75.8% of the neonates and very low in 24.2%. Twelve (4.2%) of the neonates had TSH levels >40µIU/ml with a mean TSH of 61.7±14.7 µIU/ml and a mean T4 of 7.7±3.7µg/dl.

Conclusions: About 4.2% of neonates are at risk of congenital hypothyroidism with High TSH and low T4 values, T3 values are undetectable or very low in late prenatal life.


Keywords


Cord serum, Thyroid hormones, Neonates

Full Text:

PDF

References


Bianco AC, Salvatore D, Gereben B, Berry, MJ, Larsen PR. Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases. Endocrinol Rev. 2002;23,(1):38-89.

Hume R, Simpson J, Delahunty C, Toor HV. Human fetal and cord serum thyroid hormones: developmental trends and interrelationships. J Clin Endocrinol & Metab. 2004;89:4097-103.

Videla LA, Fernández V, Tapia G, Varela P. Thyroid hormone calorigenesis and mitochondrial redox signaling: upregulation of gene expression. Front Biosci. 2007;12:1220-8.

Gaudino R, Garel C, Czemichow P, Leger J. Proportion of various type of thyroid disorder among newborns with congenital hypothyroidism and normally located gland: a regional cohort study. Clin Endocrinol (Oxford). 2005;62:444.

Glinoer D. Potential consequences of maternal hypothyroidism on the offspring: evidence and implications. Horm Res. 2001;55:109-14.

Zoeller RT. Transplacental thyroxine and fetal brain development. J Clin Invest. 2003;111(7):954-7.

Larson C, Hermos R, Delaney A, Daley D, Mitchell M. Risk factors associated with delayed thyrotropin elevation in congenital hypothyroidism. J Pediatr. 2003;143:587-91.

Cairo MS, Wagner JE. Placental and/or umbilical cord blood: an alternative source of hematopoietic stem cells for transplantation. Blood. 1997;90,(12):4665-78.

Furuhashi N, Fukaya T, Kono H, Kull P. Cord Serum growth hormone in the human fetus. Sex difference and a negative correlation with birth weight. Gynecol Obstet Invest. 1983;16:119-24.

Nicholson JF, Pesce MA. Laboratory medicine and reference tables. In: Behrman RE, Kleigman RM, Arvin AN. eds., Textbook of Paediatrics, 15th ed. Philadelphia: W.B. Saunders. 1996:2031-2084.

Muhlendahl KE, Pachaly J, Schmidt GM. Lack of correlation between clinical data and growth hormone concentrations in cord blood. Biology of Neonate. 1976;29:281-5.

Schall RF, Fraser AS, Hansen HW, Kern CW, Teneso HJ. A sensitive manual enzyme immunoassay for thyroxine. Clin Chem. 1978;24,(10):1801.

Uotila M, Ruoslahti E, Engvall E. Methods. J Immunol. 1981;42:11-5.

Smith L. Updated American Academy of Pediatrics (AAP) Guidelines on newborn screening and therapy for congenital hypothyroidism. Am Fam Physicians. 2007;76,(3):439-44.

Santini F, Chiovato L, Ghirri P, Lapi P, Mammoli C. Serum iodothyronines in the human fetus and the newborn: evidence for an important role of placenta in fetal thyroid hormone homeostasis. J Clin Endocrinol & Metab. 1999;84:493-8.

Kester MH, Martinez de Mena R, Obregon MJ, Marinkovic D, Howatson A, Visser TJ, et al. Iodothyronine levels in the human developing brain: major regulatory roles of iodothyronine deiodinases in different areas. J Clin Endocrinol Metab. 2004;89,(7):3117-28.

Sperling MA. Pediatric endocrinology. 3rd ed. Philadelphia: Saunders. 2008.

Manglik AK, Chatterjee N, Ghosh G. Umbilical Cord Blood TSH Levels in Term Neonates: A Screening Tool for Congenital Hypothyroidism. Indian Pediatr. 2005;42(17):1029-32.

Virmani A, Kulkarni A. Congenital Hypothyroidism: Need for Universal Neonatal Screening. Apollo Med. 2005;4(2):357-63.

Seema K, Madhulika K. Newborn screening in India: current perspectives. Indian Pediatr. 2010;47:219-24.

Ogunkeye OO, Roluga AI, Khan FA. Resetting the detection level of cord blood thyroid stimulating hormone (TSH) for the diagnosis of congenital hypothyroidism. J Trop Paediatr. 2008;54(1):74-7.

Lafranchi S. Hypothyroidism in: Behrman RE, Kleigman RM, and Jenson HB, editors. Nelson Textbook of Peadiatrics, 17th edition. Philadelphia; Saunders. 2004:1872-1879.

Desai MP, Colaco MP, Ajgaokar AR, Mahadik CV, Rege C, Shirodkar VV. Neonatal Screening for congenital hypothyroidism in a developing country: problems and strategies. Indian J Paediatr. 1987;54:571-81.

Ordookhani A, Mirmiran P, Najafi R, Hedayati M, Azizi F. Congenital hypothyroidism in Iran. Indian J of Paediatr. 2003;70:625-8.

Devi AR, Naushad SM. Newborn screening in India. Indian J Peadiatr. 2004;71:157-60.

Fatourechi V. Subclinical hypothyroidism: an update for primary care physicians. Mayo Clin Proc. 2009;84(1):65-71.

Patel J, Landers K, Li H, Mortimer RH, Richard K. Thyroid hormones and fetal neurological development. J Endocrinol. 2011;209:1-8.

Dussault JH. The Anecdotal history of screening for congenital hypothyroidism. J Clin Endocrinol Metab. 1999;84:4332-4334.

Fagela-Domingo C, Padilla CD, Cutiongco EM. Screening for congenital hypothyroidism (CH) among Filipino newborn infants. Philippine Newborn Screening Study Group. Southeast Asian J Trop Med & Pub Health. 1999;30(2):20-2.

Feleke Y, Enquoselassie F, Deneke F, Abdulkadir J, Hawariat GW, Tilahun M. Neonatal congenital hypothyroidism screening in Addis Ababa, Ethiopia. East Afr Med J. 2000;77:377-81.

Wu LL, Sazali BS, Adeeb N, Khalid BAK. Congenital hypothyroid screening using cord blood Thyroid Stimulating Hormone. Singapore Med J. 1999;40:23-6.

Adeniran KA, Okola AA, Onyiriuka AN. Thyroid profile of term appropriate for gestational age neonates in Nigeria: a forerunner to screening for congenital hypothyroidism. J Trop Pediatr. 2010;56(5):329-32.