Normal Values And Variation Of Thyroid Stimulating Hormone (Tsh) In Cord Blood Of Babies Bornover A Period Of 1 Year

Abstract

A hospital-based prospective study was conducted with 1200 neonates to evaluate the normal values of cord blood TSH and its variations among term babies and identify maternal factors affecting the cord blood TSH. Majority of the mothers (53.8%) were in the age group of 26-35 years.44.6% mothers were primigravida, None of the mothers had a history of anti-thyroid drug intake or a history of maternal goitre. Majority of the mothers (97.1%) were from a rural area, 70 (55.11%) and 22 (17.32%) mothers developed hypertension and hypothyroidism respectively while 20 (15.74%) and 15 (11.81%) patients developed Gestational diabetes mellitus and HTN+GDM respectively of 127 mothers with antenatal complications: 708 (59%) and 48 (4%) newborns delivered through Normal Vaginal Delivery. Maximum neonates (98.9%) were Appropriate for Gestational Age (AGA) while 0.8%. The incidence of male and female neonates was 640 (53.3%) and 560 (46.7%) respectively.  655 (54.6%) and 531 (44.3%) neonates weighed in the range of 2.501 – 3.000 kgs and 3.001– 3.500 kgs respectively. 1125 (93.7%) neonates had an APGAR score of 5-7. Eighty-two neonates had CBTSH level of >20mIU/L. Eighty-two neonates with CBTSH level of >20mIU/L were followed up on 7thday and 21stday of life. On 7th day, 12 neonates had raised TSH and low T4. On the 21st day out of these 12 neonates, only two neonates had significant raised TSH and low values of T4. Treatment was started for these two neonates. The CBTSH levels were found to increase with increasing maternal age. There was a significant association of CBTSH levels and maternal age, mode of delivery, antenatal complications. There is an urgent need for adopting universal screening of all neonates for congenital hypothyroidism. Babies with CBTSH levels of >20mIU/L should be evaluated on 7th and 21st day of life for TSH and T4 levels for earlier interpretation of congenital hypothyroidism.