HIGH INCIDENCE OF CONGENITAL HYPOTHYROIDISM
IN ONE REGION OF THE REPUBLIC OF MACEDONIA
Anastasovska V, Koviloska R, Kocova M,
*Corresponding Author: Professor Dr. Mirjana Kocova, University Clinic of Pediatrics, Vodnjanska 17, 1000 Skopje,
Republic of Macedonia. Tel.: +389(0)2-3123-224. Fax: +389(0)2-3111-713. E-mail: mirjanakocova@ yahoo.com
page: 31
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RESULTS
During the period of almost 10 years, out of
10,446 live birth neonates, 9757 newborns (5603
males, 4154 females) have been screened. Ethnic distribution
of the screened newborns in Prilep was as
follows: 73.3% Macedonians, 17.2% Romany, 5.6%
Albanians and 3.9% other ethnicities. Compared to
the state average, the Romany population is overrepresented
in this region (17.2% vs. 7.0%). According
to the birth weight, neonates were devided in two
groups: above 2500 gr (92.9%) and below 2500 gr
(7.1%). The coverage of the screened newborns was
93.4% average. The TSH level was not significantly
dependent on the gender of the newborn. There was
a statistically significant difference between the TSH
level and the timing of newborn screening sampling,
before and after 48 hours of birth (p <0.05) (Figure
1). There was also a statistically significant difference
between the TSH level and newborn birth
weight, above or below 2500 gr (p = 0.01) (Figure
2). A statistically significant predictor of the TSH
level was only the timing of newborn screening sampling
(p <0.05). Spearman’s correlation coefficient
between TSH level, newborn birth weight and gestational
age showed a significant positive correlation
between birth weight and gestational age (r = 0.369, p<0.01). During the analyzed period, 1.92% newborns
had TSH levels above 5 mU/L, indicating iodine sufficiency
in Prilep.
The percentage of recalled neonates with borderline
or abnormal initial TSH values was 0.18%.
Out of 18 recalled neonates, 10 (55.6%) were categorized
as healthy neonates and eight (44.4%) were
diagnosed as CH cases. The incidence of the disease
was 1:1220 live births. Among neonates with CH,
five (62.5%) were male and three (37.5%) were female
(male-to-female ratio 1.6:1). The prevalence of
CH among male and female neonates was 0.89/1000
(1:1121) and 0.56/1000 (1:1776), respectively. The
difference was statistically significant (p <0.05).
The distribution of TSH levels showed that seven
(87.1%) of the diagnosed CH neonates had initial
TSH values above 20 mU/L. One newborn (12.5%)
had a borderline initial TSH value, 11.3 mU/L. The
thyroid gland was undetectable on ultrasound in four
(50.0%) newborns with CH, thyroid hypoplasia of
one lobe was confirmed in two (25.0%), and two
(25.0%) had a normal thyroid gland. The median age
of treatment initiation with levothyroxin was 10.5
days after birth (6-12 days). Infants diagnosed with
CH were closely followed during the first 3 years of
life. They were followed-up every 2 months during
the first year of life, and every 3 months during the
second and third year.
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