Abstract
Objectives
An increased incidence of congenital hypothyroidism (CH) has been described worldwide over the years. In this study, we aimed to investigate the epidemiologic characteristics of CH, the iodine status in Guangzhou, China and to investigate which factors might influence the CH incidence during the period 2010–2020.
Methods
We retrospectively reviewed all cases of CH detected by newborn screening during the period 2010–2020. CH was classified as either suspected thyroid dyshormonogenesis (SDH) or thyroid dysgenesis (TD) based on thyroid ultrasound at first diagnosis. Patients were re-evaluated after 4 weeks of L-thyroxine withdrawal at age of 2–3 years to confirm the diagnosis of permanent CH (PCH) or transient CH (TCH).
Results
From 2010 to 2020, 1,655 patients with CH were confirmed from 2,400,383 newborns (1:1,450). The CH incidence increased from 1:2,584 in period [2010–2014] to 1:1,086 in period [2015–2020]. Among the 1,337 patients with thyroid ultrasound, 84.29% were SDH whereas 15.71% had TD. Further analysis revealed that more SDH (78.32%) were TCH whereas more TD (87.12%) turned to be PCH. The proportion of blood spot thyrotropin values >5 mIU/L ranged from 8.03 to 20.46%, indicating iodine deficiency. The prevalence of preterm infants increased from 5.50% in period [2010–2014] to 7.06% in period [2015–2020] (p<0.001).
Conclusions
In the past decade, the CH incidence has increased progressively. SDH was the majority of CH, most of which were TCH, while most patients with TD were PCH. The increased incidence might be mainly due to iodine deficiency and increased rates of preterm infants in our study.
Funding source: Guangzhou Science, Technology and Innovation Commission
Award Identifier / Grant number: 201510010010
Acknowledgments
We thank the patients and their parents for consenting to participate in this study.
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Research funding: This work was supported by Science and Technology Program of Guangzhou, China (Grant 201510010010).
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: This study was performed with the approval of the Ethics Committee of Guangzhou Women and Children’s Medical Center.
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