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ESPE2022 Rapid Free Communications Thyroid (6 abstracts)

“Screening for congenital hypothyroidism in preterm newborns: Thyroid Stimulating Hormone (TSH) percentiles for weight and gestational age and congenital hypothyroidism features”

Gerdi Tuli 1,2 , Jessica Munarin 1,2 , Kristela Topalli 1,2 , Daniele Tessaris 1,2 , Patrizia Matarazzo 1,2 & Luisa De Sanctis 1,2

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1Department of Pediatric Endocrinology, Regina Margherita Children's Hospital, Turin, Italy; 2Department of Public Health and Pediatrics, University of Turin, Turin, Italy

Background: Preterm newborns (PN) are at risk of developing congenital hypothyroidism (CH) with a high reported incidence (1:300 vs 1:2000 for at term newborns). The study's objective was to determine the TSH percentiles at neonatal screening (NS) in PN and to analyze the incidence of permanent and transient CH in this population.

Materials and Methods: PN born in the Piedmont Region of Italy in the period 2019-2021 were included.

Results: NS was performed by TSH detection on Guthrie cards in 5930 PN. The first TSH analysis was made at 3.3 ±1.48, the second at 15±1.4 and the third at 26.8±15.4 days of life. TSH mean levels and percentiles are represented in Table 1.

Table 1. Mean TSH levels and percentiles during NS in PN.
  Mean 1° 3° 25° 50° 75° 97° 99°
1st detection (n=5930) 2.3±0.02 0.2 0.4 1.17 1.9 3 6.4 8.5
2nd detection (n=5130) 1.77±0.02 0.3 0.4 1 1.5 2.2 4.5 5.7
3rd detection (540) 1.56±0.02 0.2 0.36 1.1 1.6 2.55 4.7 5.17

TSH levels considering weight and gestational age (GA) are shown in Table 2 and 3, respectively.

Table 2. TSH percentiles for weight at NS in PN.
  Neonatal weight    
  <1000 g 1000-1499 g 1500-2500 g >2500 g p p
1st detection 2.08±0.15 2.01±0.08 2.28±0.03 2.41±0.03 P< 0.005 P< 0.005
2nd detection 2.13±0.11 2.32±0.23 1.93±0.04 1.62±0.02 P< 0.005 P< 0.005
3rd detection 2.07±0.16 3.87±1.43 2.29±0.2 1.62±0.09 P=0.16 P=0.16
Table 3. TSH percentiles for GA at NS in PN.
  Gestational age p
22-<28 w 28-<32 w 32-<34 w 34-<37 w
1st detection 1.71±0.09 1.87±0.06 1.94±0.05 2.42±0.02 P< 0.005
2nd detection 1.89±0.11 2.15±0.21 2.2±0.16 1.75±0.02 P< 0.005
3rd detection 1.75±0.14 2.11±0.13 2.62±0.24 1.94±0.14 P=0.01

NS results for each TSH detection are depicted in Table 4. CH incidence was 1:156; in those born in 2019-20 the percentage of transient CH was 65%.

Table 4. NS results for each TSH detection.
  Normal TSH re-evaluation by screening Serum TSH evaluation CH
1st detection 5850 73 - 7
2nd detection 5232 10 39 29
3rd detection 521 - 17 2

Conclusion: The incidence of CH in PN is much higher than in at term infants. In PN, targeted NS strategies are needed which should consider both neonatal weight and GA.

Volume 95

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60th Annual ESPE (ESPE 2022)

Rome, Italy
15 Sep 2022 - 17 Sep 2022

European Society for Paediatric Endocrinology 

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