FREQUENCY OF CONGENITAL HYPOTHYROIDISM IN PRETERM AND LOW BIRTH WEIGHT NEONATES IN A TERTIARY CARE HOSPITAL
DOI:
https://doi.org/10.54112/pjicm.v5i02.129Keywords:
Congenital Hypothyroidism; Preterm Neonates; Low Birth Weight; TSH Screening; Neonatal Endocrine Disorders.Abstract
Background: Congenital hypothyroidism (CH) is a preventable cause of neurodevelopmental impairment. Preterm and low birth weight neonates are at heightened risk and may require repeat thyroid-stimulating hormone (TSH) screening to avoid missed or delayed diagnoses. Objective: To determine the frequency of CH in preterm and low birth weight neonates admitted to a tertiary care hospital and to explore its association with key perinatal variables. Study Design: Descriptive cross-sectional study. Settings: Department of Pediatrics, Chaudhry Muhammad Akram Teaching and Research Hospital, Lahore, Pakistan. Duration of Study: 3 December 2024 to 3 June 2025. Methods: A total of 165 neonates who were preterm (<37 weeks' gestation) or low birth weight (<2500 g) were enrolled through non-probability consecutive sampling. Dried blood spot specimens were analyzed for TSH using an immunoradiometric assay. CH was defined as TSH ≥20 mIU/L. Associations between CH status and age at testing, sex, gestational age, and mode of delivery were evaluated with a two-sided α of 0.05. Results: The mean gestational age was 33.29 ± 1.78 weeks, and the mean birth weight was 1841.56 ± 310.97 g. CH was detected in 10.3% (n=17/165) of neonates. There was no statistically significant association between CH and age at testing (p=0.704), sex (p=0.778), gestational age (p=0.923), or mode of delivery (p=0.189). Conclusion: A notably high frequency of CH was observed among preterm and low birth weight neonates in this tertiary care setting. These data support routine and repeat TSH screening in this high-risk population to enable timely diagnosis and initiation of therapy.
References
Bowden SA, Goldis M. Congenital hypothyroidism. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. [Updated 2023 Jun 5; cited 2025 Aug 14]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558913/
Korkmaz HA. Clinical insight into congenital hypothyroidism among children. Children (Basel). 2025;12(1):55. https://doi.org/10.3390/children12010055.
Ontiveros-Mendoza E, González-Medrano JA, Rivera-González R, Sánchez-Huerta K, Sánchez C, Barragán-Mejía G, et al. Congenital hypothyroidism and associated visual-motor and intellectual development. Pediatr Res. 2025. https://doi.org/10.1038/s41390-025-03850-3.
Gudaganatti L, Sajjan SG, Khursheed R. Screening for congenital hypothyroidism by using cord blood thyroid-stimulating hormone (CBTSH) levels in neonates. J Family Med Prim Care. 2025 Apr;14(4):1375–8. https://doi.org/10.4103/jfmpc.jfmpc_1393_24
Cherella CE, Wassner AJ. Congenital hypothyroidism: insights into pathogenesis and treatment. Int J Pediatr Endocrinol. 2017;2017:11. https://doi.org/10.1186/s13633-017-0051-0
Klosinska M, Kaczynska A, Ben-Skowronek I. Congenital hypothyroidism in preterm newborns—The challenges of diagnostics and treatment: a review. Front Endocrinol (Lausanne). 2022;13:860862. https://doi.org/10.3389/fendo.2022.860862
Liu C, Wang K, Guo J, Chen J, Chen M, Xie Z, et al. Small for gestational age is a risk factor for thyroid dysfunction in preterm newborns. BMC Pediatr. 2020;20(1):179. https://doi.org/10.1186/s12887-020-02089-7
Brown EDL, Obeng-Gyasi B, Hall JE, Shekhar S. The thyroid hormone axis and female reproduction. Int J Mol Sci. 2023;24(12):9815. https://doi.org/10.3390/ijms24129815
Babić Leko M, Gunjača I, Pleić N, Zemunik T. Environmental factors affecting thyroid-stimulating hormone and thyroid hormone levels. Int J Mol Sci. 2021;22(12):6521. https://doi.org/10.3390/ijms22126521
Skrinska V, Khneisser I, Schielen P, Loeber G. Introducing and expanding newborn screening in the MENA region. Int J Neonatal Screen. 2020;6(1):12. https://doi.org/10.3390/ijns6010012
Akram MS, Hussain F, Mateen M, Ali AS. Frequency of congenital hypothyroidism in preterm and low birth weight neonates. Pakistan Postgraduate Medical Journal. 2022;33(1):20–23. https://doi.org/10.51642/ppmj.v33i01.345
American Academy of Pediatrics; Rose SR; Section on Endocrinology and Committee on Genetics. Update of newborn screening and therapy for congenital hypothyroidism. Pediatrics. 2006;117(6):2290–2303. https://doi.org/10.1542/peds.2006-0915
Léger J, Olivieri A, Donaldson M, Torresani T, Krude H, van Vliet G. European Society for Paediatric Endocrinology consensus guidelines on screening, diagnosis, and management of congenital hypothyroidism. Horm Res Paediatr. 2014;81(2):80–103. https://doi.org/10.1159/000358198
Korzeniewski SJ, Grigorescu V, Kleyn M, Young WI, Todem D, Pajkrt E, et al. Transient hypothyroidism at 3-year follow-up among cases detected by newborn screening. J Pediatr. 2013;162(1):177–182. https://doi.org/10.1016/j.jpeds.2012.06.050
American Thyroid Association. Guidelines for the screening and management of preterm infants with congenital hypothyroidism. Thyroid. 2006;16(10):1109–1110
Perry RJ, Maraki I, Awogbade M, Vaidya B. Clinical review: Screening for primary hypothyroidism: is TSH enough? Ann Clin Biochem. 2009;46(Pt 5):389–394.
Rastogi MV, LaFranchi SH. Congenital hypothyroidism. Orphanet J Rare Dis. 2010;5:17. https://doi.org/10.1186/1750-1172-5-17
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 F SHEHZAD , A SIDDIQA , RA RANA , A ZAHID , IA AZHAR , J ZAHID

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.