Article Type
Article
Abstract
Background: Congenital hypothyroidism (CH) is one of the most common yet preventable endocrine disorders in neonates, with early diagnosis being critical to avert permanent neurodevelopmental impairment. Despite global efforts promoting universal newborn screening, Iraq lacks a comprehensive screening infrastructure, potentially delaying timely diagnosis and intervention. This study aimed to evaluate the biochemical and clinical features associated with suspected CH in neonates at a tertiary hospital in Iraq, focusing on thyroid-stimulating hormone (TSH), free thyroxine (FT4), and triiodothyronine (T3) levels.
Methods: A cross-sectional analysis was conducted on 89 neonates (≤30 days old) presenting with either abnormal initial TSH screening or clinical signs suggestive of CH. Serum levels of TSH, FT4, and T3 were measured using electrochemiluminescence immunoassay. Demographic and clinical data were also recorded. Statistical comparisons were made between neonates diagnosed with CH and those without, using a significance threshold of p < 0.05.
Results: Among the 89 neonates, 20 (22.5%) were confirmed to have primary CH, defined by elevated TSH (>20 mIU/L) and reduced FT4 (<10 pmol/L). These cases exhibited significantly higher mean TSH (32.6 ± 8.1 mIU/L) and lower FT4 levels (7.8 ± 1.2 pmol/L) compared to non-CH counterparts (5.4 ± 2.2 mIU/L and 15.4 ± 3.6 pmol/L, respectively; p = 0.05). Clinical features most frequently observed included prolonged jaundice (47.2%), hypotonia (33.7%), and constipation (21.3%). No significant associations were found between CH and sex or gestational age. A strong inverse correlation was identified between TSH and FT4 levels (r = –0.78, p = 0.05).
Conclusion: This study highlights the substantial burden of undiagnosed CH among neonates in Iraq and reinforces the diagnostic value of combined TSH and FT4 screening. In the absence of a national newborn screening program, hospital-based biochemical evaluation remains an essential strategy for early detection.
Keywords
Congenital hypothyroidism, Neonatal screening, Thyroid hormones, Newborn health, TSH, FT4, Early diagnosis
Recommended Citation
Habeeb, Hailah Othman; Hussein, Bushra Mahmood; Hussein, Zuhair Maroof; and Abed, Hayder H.
(2025)
"Biochemical and Clinical Evaluation of Suspected Congenital Hypothyroidism Among Neonates in Iraq,"
Muthanna Medical Journal: Vol. 12:
Iss.
2, Article 1.
Available at:
https://muthmj.mu.edu.iq/journal/vol12/iss2/1
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
