Neonatal screening for congenital hypothyroidism in Sweden 1980-2013: effects of lowering the thyroid-stimulating hormone threshold
Authors' conclusion
Despite high efficacy of the CH screening, 50% of children diagnosed as CH was screening negative. Although other factors influencing the incidence of the CH diagnosis cannot be ruled out, the incidence of screening negative CH decreased with lowering of the TSH threshold. Birth characteristics differed between screening positive and negative CH.
Study context
- Population
- All children in the Swedish Medical Birth Register and national cohort of screening-positive infants (n = 1577), 1980–20131,577 screening positive
- Participants
- 3,427,240 children
- Exposure
- Before vs after lowering the thyroid-stimulating hormone (TSH) screening threshold in 2009
- Outcome
- Incidence of CH (screening positive and screening negative) before and after lowering the TSH screening threshold
Methodological detailsIncidence estimated by Clopper-Pearson method, Evaluation against levothyroxine use in first year of life as reference
- Incidence estimated by Clopper-Pearson method
- Evaluation against levothyroxine use in first year of life as reference
Main finding
As reported in the abstract
Incidence of screening positive congenital hypothyroidism (CH) increased
1/3375 to 1/2222
Incidence of screening negative CH decreased
1/2563 to 1/7841
Children with a CH diagnosis who were screening negative
50%
Observational data: associations, not effects.
Further findings
Screening negative CH: associated factors and transient disease
- Screening negative CH with transient disease
- 42%
- Screening negative CH associated with female sex, twinning, prematurity, low birth weight, birth defects and need of neonatal intensive care
Original publication
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