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

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). Spearmanís 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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