Document Type : Original Article

Authors

1 Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, School of Nursing and Midwifery, Isfahan University of Medical Science

2 Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences

3 Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences Department of Pediatrics, Emam Hossein Children's Hospital, Isfahan Univer

4 Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences

5 Isfahan Health Center, Colleague of Congenital Hypothyroidism Screening Program, Isfahan University of Medical Sciences, Isfahan, Iran

6 Department of Pediatrics, Emam Hossein Children's Hospital, Isfahan University of Medical Sciences

7 Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University

Abstract

BACKGROUND: Considering the high prevalence rate of congenital hypothyroidism CH in Iran, an
epidemiological study in each region would be helpful in understanding the etiology of the disorder
and providing preventative strategies in this field. This study aims to determine the prevalence of
CH in different cities of the Isfahan province.
MATERIALS AND METHODS: This descriptive and retrospective study was conducted among 918
primarily diagnosed CH neonates, who have been identified through the neonatal screening program
from 2009 to 2015. At the age of ≥3 years, treatment was discontinued for 4 weeks, and T4 and
thyroid‑stimulating hormone were measured. Permanent (PCH) or transient (TCH) was determined
from the results of the thyroid function tests.
RESULTS: From 389,101 screened neonates, 918 were diagnosed with primary CH. The overall
prevalence rate of CH was 2.36 in 1000 live birth (ranged 1.58–7.22 in 1000 live birth in different
cities). The highest prevalence rate of CH was reported in Ardestan, Khansar, Golpaygan, and Nain
cities with prevalence rate of 4.86–7.22 in 1000 live birth and lowest prevalence occurring in Fereydan,
Shahreza, Isfahan, and Mobarakeh cities with prevalence rate of 1.58–1.89 in 1000 live birth. In
392 cases which reached to 3 years of age, the rate of TCH was 47.45%. In Chadegan, Natanz,
Fereydunshahr, Shahinshahr, Najafabad, Dehaghan, Borkhar, and Mobarakeh, the prevalence of
PCH was <50%.
CONCLUSION: The current findings indicate that the incidence rate of both PCH and TCH are
high in Isfahan province with significant variability in different cities which could be due to the role
of different genetic, prenatal, and different environmental factors. These epidemiological data could
be used as baseline date to design more etiological studies.

Keywords

  1. Adeniran KA, Limbe M. Review article on congenital
    hypothyroidism and newborn screening program in Africa; the
    present situation and the way forward. Thyroid Disord Ther
    2012;1:102.
    2. Dilli D, Çzbaş S, Acıcan D, Yamak N, Ertek M, Dilmen U.
    Establishment and development of a national newborn screening
    programme for congenital hypothyroidism in Turkey. J Clin Res
    Pediatr Endocrinol 2013;5:73‑9.
    3. Alawneh H. Incidence of congenital hypothyroidism in Jordan.
    Menoufia Med J 2014;27:503‑6.
    4. Ghasemi M, Hashemipour M, Hovsepian S, Heiydari K, Sajadi A,
    HadianR, et al. Prevalence of transient congenital hypothyroidism
    in central part of Iran. J Res Med Sci 2013;18:699‑703.
    5. Haghshenas M, Pasha YZ, Ahmadpour‑Kacho M, Ghazanfari S.
    Prevalence of permanent and transient congenital hypothyroidism
    in Babol city – Iran. Med Glas 2012;9:341‑4.
  2. 6. Jurayyan NA, Jurayyan RN. Congenital hypothyroidism and
    neonatal screening in Saudi Arabia. Curr Pediatr Res 2012;16:31‑6.
    7. Büyükgebiz A. Newborn screening for congenital hypothyroidism.
    J Clin Res Pediatr Endocrinol 2013;5 Suppl 1:8‑12.
    8. Abduljabbar MA, Afifi AM. Congenital hypothyroidism. J Pediatr
    Endocrinol Metab 2012;25:13‑29.
    9. Bhavani N. Transient congenital hypothyroidism. Indian J
    Endocrinol Metab 2011;15:S117‑20.
    10. Hulur I, Hermanns P, Nestoris C, Heger S, Refetoff S, Pohlenz J,
    et al. A single copy of the recently identified dual oxidase
    maturation factor(DUOXA) 1 gene produces only mild transient
    hypothyroidism in a patient with a novel biallelic DUOXA2
    mutation and monoallelic DUOXA1 deletion. J Clin Endocrinol
    Metab 2011;96:E841‑5.
    11. Hashemipour M, Ghasemi M, Hovsepian S, Heiydari K,
    Sajadi A, Hadian R, et al. Prevalence of permanent congenital
    hypothyroidism in Isfahan‑Iran. Int J Prev Med 2013;4:1365‑70.
    12. Hashemipour M, Hovsepian S, Kelishadi R, Iranpour R,
    Hadian R, Haghighi S, et al. Permanent and transient congenital
    hypothyroidism in Isfahan‑Iran. J Med Screen 2009;16:11‑6.
    13. Wassner AJ, Brown RS. Congenital hypothyroidism: Recent
    advances. Curr Opin Endocrinol Diabetes Obes 2015;22:407‑12.
    14. Sun Q, ChenYL, YuZB, Han SP, DongXY, QiuYF, et al. Long‑term
    consequences of the early treatment of children with congenital
    hypothyroidism detected by neonatal screening in Nanjing,
    China: A 12‑year follow‑up study. J Trop Pediatr 2012;58:79‑80.
    15. Dias VM, Campos AP, Chagas AJ, Silva RM. Congenital
    hypothyroidism: Etiology. J Pediatr Endocrinol Metab
    2010;23:815‑26.
    16. Karamizadeh Z, Dalili S, Sanei‑Far H, Karamifard H,
    Mohammadi H, Amirhakimi G. Does congenital hypothyroidism
    have different etiologies in Iran? Iran J Pediatr 2011;21:188‑92.
    17. Kanike N, Davis A, Shekhawat PS. Transient hypothyroidism in
    the newborn: To treat or not to treat. Transl Pediatr 2017;6:349‑58.
    18. Ordookhani A, Mirmiran P, Moharamzadeh M, Hedayati M,
    Azizi F. A high prevalence of consanguineous and severe
    congenital hypothyroidism in an Iranian population. J Pediatr
    Endocrinol Metab 2004;17:1201‑9.
    19. al‑Jurayyan NA, Shaheen FI, al‑Nuaim AA, el‑Desouki MI,
    Faiz A, al Herbish AS, et al. Congenital hypothyroidism: Increased
    incidence in Najran Province, Saudi Arabia. J Trop Pediatr
    1996;42:348‑51.
    20. Gaudino R, Garel C, Czernichow P, Léger J. Proportion of various
    types of thyroid disorders among newborns with congenital
    hypothyroidism and normally located gland: A regional cohort
    study. Clin Endocrinol (Oxf) 2005;62:444‑8.
    21. Korzeniewski SJ, Grigorescu V, Kleyn M, Young WI, Birbeck G,
    Todem D, et al. Transient hypothyroidism at 3‑year follow‑up
    among cases of congenital hypothyroidism detected by newborn
    screening. J Pediatr 2013;162:177‑82.
    22. Kang MJ, Chung HR, Oh YJ, Shim YS, Yang S, Hwang IT.
    Three‑year follow‑up of children with abnormal newborn
    screening results for congenital hypothyroidism. Pediatr Neonatol
    2017;58:442‑8.
    23. Bekhit OE, Yousef RM. Permanent and transient congenital
    hypothyroidism in Fayoum, Egypt: A descriptive retrospective
    study. PLoS One 2013;8:e68048.
    24. Hashemipour M, Dehkordi EH, Hovsepian S, Amini M,
    Hosseiny L. Outcome of congenitally hypothyroid screening
    program in Isfahan: Iran from prevention to treatment. Int J Prev
    Med 2010;1:92‑7.
    25. McElduffA, McElduffP, WileyV, WilckenB. Neonatal thyrotropin
    as measured in a congenital hypothyroidism screening program:
    Influence of the mode of delivery. J Clin Endocrinol Metab
    2005;90:6361‑3.
    26. Turan S, Bereket A, Angaji M, Koroglu OA, Bilgen H, Onver T,
    et al. The effect of the mode of delivery on neonatal thyroid
    function. J Matern Fetal Neonatal Med 2007;20:473‑6.
    27. Miyamoto N, Tsuji M, Imataki T, Nagamachi N, Hirose S,
    HamadaY. Influence of mode of delivery on fetal pituitary‑thyroid
    axis. Acta Paediatr Jpn 1991;33:363‑8.
    28. Khazaei Z, Goodarzi E, Ghaderi E, Khazaei S, Alikhani A,
    Ghavi S, et al. The prevalence of transient and permanent
    congenital hypothyroidism in infants of Kurdistan Province,
    Iran (2006‑2014). Int J Pediatr 2017;5:4309‑18.
    29. Hashemipour M, Amini M, Talaie M, Kelishadi R, Hovespian S,
    Iranpour R, et al. Parental consanguinity among parents of
    neonates with congenital hypothyroidism in Isfahan. East
    Mediterr Health J 2007;13:567‑74.
    30. Hashemipour M, Hovsepian S, Kelishadi R. High prevalence of
    congenital hypothyroidism in Isfahan: Do familial components
    have a role? Adv Biomed Res 2012;1:37.
    31. Kirmızibekmez H, Güven A, Yildiz M, Cebeci AN, Dursun F.
    Developmental defects of the thyroid gland: Relationship with
    advanced maternal age. J Clin Res Pediatr Endocrinol 2012;4:72‑5.
    32. Dayal D, Sindhuja L, Bhattacharya A, Bharti B. Advanced maternal
    age in Indian children with thyroid dysgenesis. Clin Pediatr
    Endocrinol 2015;24:59‑62.
    33. Eugster EA, LeMay D, Zerin JM, Pescovitz OH. Definitive
    diagnosis in children with congenital hypothyroidism. J Pediatr
    2004;144:643‑7.
    34. Hashemipour M, Ghasemi M, Hovsepian S, Heiydari K, Sajadi A,
    Hadian R, et al. Etiology of congenital hypothyroidism in Isfahan:
    Does it different? Adv Biomed Res 2014;3:21.