• 作者：T. Arrobas Velilla^a ; C. Gonzá ; lez Rodrí ; guez^a ; ^{concepcion.gonzalez.r.sspa@juntadeandalucia.es} ; A. Barco Sá ; nchez^a ; C. Morales Portillo^b ; J.A. Bermú ; dez de la Vega^c ; S. Bernal Cerrato^c ; A. Gentil Baldrich^b ; J.M. Guerrero Montá ; vez^a ; A. Sendó ; n Pé ; rez^b ; J.M. Gonzá ; lez de Buitrago Arriero^d ; R. Goberna Ortiz^a
• 关键词：Hipotiroidismo cong&eacute ; nito ; Hipertirotropinemia ; Deficiencia de yodo ; Programa de cribado neonatal
• 刊名：Anales de Pediatr¨ªa
• 出版年：2010
• 出版时间：February 2010
• 年：2010
• 卷：72
• 期：2
• 页码：121-127
• 全文大小：548 K

Background

Neonatal hyperthyrotropinemia by measurements of thyrotropin (TSH) concentrations has been assessed in three different areas of Spain. The repercussions of a possible iodine deficiency in a congenital hypothyroidism screening program have also been analysed

Material and Methods

The study comprised 113,108 newborns, which were divided into two groups according to the time of blood sampling. In 78,646 newborns heel blood samples were obtained after 48 h whereas in 34,462 newborns, samples were obtained at birth from the umbilical cord (early samples). Newborns came from three areas of the south of Spain, Seville, Huelva and Cordoba. TSH concentrations were measured by time-resolved fluoroimmunoassay.

Results

The percentage of hyperthyrotropinemia was greater in Huelva (5.2 % ) than Seville (1.0 % ) (p<0.001), similar to that observed in early samples, which was higher in Huelva (5.3 % ) than in Seville (1.9 % ) and Cordoba (1.7 % ) (p<0.001). In the early samples group, 0.3 % and 0.2 % of the newborns from Seville and Cordoba respectively, had TSH >20 mIU/L and 10 infants should have been recalled for a new sample for each case detected. While in Huelva 17 infants (0.9 % ) were recalled per case detected.

Conclusions

The heterogeneous distribution of TSH concentrations in newborns from several geographical areas appears to indicate an irregular and deficient iodine intake. Using early samples and a possible iodine deficiency, increase false positive results in a Neonatal Screening Program of congenital hypothyroidism.