Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases

CONTEXT: Screening programs not only offer the opportunity to trace and treat almost all cases of congenital hypothyroidism but also mean large savings to the health system. However, carefully planned strategies are necessary to extend their benefits and reduce costs. OBJECTIVE: To determine the pos...

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Autores: Ward, Laura Sterian, Kunii, Ilda Shizue, Maciel, Rui Monteiro de Barros
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2000
País:Brasil
Institución:Associação Paulista de Medicina
Repositorio:São Paulo medical journal (Online)
Idioma:inglés
OAI Identifier:oai:ojs.diagnosticoetratamento.emnuvens.com.br:article/2684
Acceso en línea:https://periodicosapm.emnuvens.com.br/spmj/article/view/2684
Access Level:acceso abierto
Palabra clave:Hipotiroidismo congênito
Rastreamento
Doença materna
Congenital hypothyroidism
Screening program
Maternal diseases
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network_acronym_str BR
network_name_str Brasil
repository_id_str
dc.title.none.fl_str_mv Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases
title Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases
spellingShingle Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases
Ward, Laura Sterian
Hipotiroidismo congênito
Rastreamento
Doença materna
Congenital hypothyroidism
Screening program
Maternal diseases
title_short Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases
title_full Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases
title_fullStr Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases
title_full_unstemmed Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases
title_sort Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases
dc.creator.none.fl_str_mv Ward, Laura Sterian
Kunii, Ilda Shizue
Maciel, Rui Monteiro de Barros
author Ward, Laura Sterian
author_facet Ward, Laura Sterian
Kunii, Ilda Shizue
Maciel, Rui Monteiro de Barros
author_role author
author2 Kunii, Ilda Shizue
Maciel, Rui Monteiro de Barros
author2_role author
author
dc.subject.por.fl_str_mv Hipotiroidismo congênito
Rastreamento
Doença materna
Congenital hypothyroidism
Screening program
Maternal diseases
topic Hipotiroidismo congênito
Rastreamento
Doença materna
Congenital hypothyroidism
Screening program
Maternal diseases
description CONTEXT: Screening programs not only offer the opportunity to trace and treat almost all cases of congenital hypothyroidism but also mean large savings to the health system. However, carefully planned strategies are necessary to extend their benefits and reduce costs. OBJECTIVE: To determine the possible influence of maternal diseases that affect maternal-fetal placenta dynamics on primary thyroid stimulating hormone (TSH) screening for congenital hypothyroidism. DESIGN: Prospective non-randomized clinical trial with at least 3 months of follow-up. SETTING: A public university referral center [CAISM/Hospital das Clínicas, Faculty of Medicine, University of Campinas, Campinas, SP]. PARTICIPANTS: 415 neonates divided into 5 groups: eighty-three infants born from cardiac mothers; 98 from mothers that had toxemia; 54 of the mothers had diabetes mellitus; 40 were HIV positive and 140 had no diseases. INTERVENTION: All newborns had cord blood samples collected on filter paper at birth. MAIN MEASUREMENTS: TSH was measured from dried blood spots using a homemade immunofluorescence assay (sensitivity in dried blood spots = 0.1 mU/L). RESULTS: There was no significant difference in the mean TSH levels among the 5 groups. Moreover, TSH levels were around 5 mU/L in 48% of the newborns, indicating that our region is severely deficient in iodine. CONCLUSIONS: Our results indicate that primary TSH screening programs using cord blood are not affected by maternal diseases. We suggest that, besides its technical advantages over heel punctures with T4 primary approaches, neonatal screening using primary cord blood TSH may also be used as a monitoring tool for evaluation and control of iodine deficiency disorders (IDD).
publishDate 2000
dc.date.none.fl_str_mv 2000-09-09
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://periodicosapm.emnuvens.com.br/spmj/article/view/2684
url https://periodicosapm.emnuvens.com.br/spmj/article/view/2684
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://periodicosapm.emnuvens.com.br/spmj/article/view/2684/2571
dc.rights.driver.fl_str_mv https://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv São Paulo Medical Journal
São Paulo Medical Journal
publisher.none.fl_str_mv São Paulo Medical Journal
São Paulo Medical Journal
dc.source.none.fl_str_mv São Paulo Medical Journal; Vol. 118 No. 5 (2000); 144-147
São Paulo Medical Journal; v. 118 n. 5 (2000); 144-147
1806-9460
reponame:São Paulo medical journal (Online)
instname:Associação Paulista de Medicina
instacron:APM
instname_str Associação Paulista de Medicina
instacron_str APM
institution APM
reponame_str São Paulo medical journal (Online)
collection São Paulo medical journal (Online)
repository.name.fl_str_mv São Paulo medical journal (Online) - Associação Paulista de Medicina
repository.mail.fl_str_mv revistas@apm.org.br
_version_ 1853676248172068864
spelling Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases Hipotiroidismo congênitoRastreamentoDoença maternaCongenital hypothyroidismScreening programMaternal diseasesCONTEXT: Screening programs not only offer the opportunity to trace and treat almost all cases of congenital hypothyroidism but also mean large savings to the health system. However, carefully planned strategies are necessary to extend their benefits and reduce costs. OBJECTIVE: To determine the possible influence of maternal diseases that affect maternal-fetal placenta dynamics on primary thyroid stimulating hormone (TSH) screening for congenital hypothyroidism. DESIGN: Prospective non-randomized clinical trial with at least 3 months of follow-up. SETTING: A public university referral center [CAISM/Hospital das Clínicas, Faculty of Medicine, University of Campinas, Campinas, SP]. PARTICIPANTS: 415 neonates divided into 5 groups: eighty-three infants born from cardiac mothers; 98 from mothers that had toxemia; 54 of the mothers had diabetes mellitus; 40 were HIV positive and 140 had no diseases. INTERVENTION: All newborns had cord blood samples collected on filter paper at birth. MAIN MEASUREMENTS: TSH was measured from dried blood spots using a homemade immunofluorescence assay (sensitivity in dried blood spots = 0.1 mU/L). RESULTS: There was no significant difference in the mean TSH levels among the 5 groups. Moreover, TSH levels were around 5 mU/L in 48% of the newborns, indicating that our region is severely deficient in iodine. CONCLUSIONS: Our results indicate that primary TSH screening programs using cord blood are not affected by maternal diseases. We suggest that, besides its technical advantages over heel punctures with T4 primary approaches, neonatal screening using primary cord blood TSH may also be used as a monitoring tool for evaluation and control of iodine deficiency disorders (IDD).CONTEXTO: Os programas de detecção precoce trazem economias ao sistema de saúde e oferecem a oportunidade de rastrear e tratar precocemente casos de hipotiroidismo congênito. OBJETIVO: Determinar influências de doenças que afetam a dinâmica materno-fetal-placentária sobre programas de detecção precoce de hipotiroidismo congênito que se baseiam na dosagem do hormônio tirotrófico (TSH). TIPO DE ESTUDO: Ensaio clínico prospectivo não-randomizado com, ao menos, três meses de seguimento. LOCAL: Centro Universitário Público de Referência - Centro de Atendimento Integrado a Saúde da Mulher (CAISM). PARTICIPANTES: 415 recém-nascidos de 5 grupos de parturientes: 83 crianças eram filhas de mães cardiopatas; 98 de mães com toxemia gravídica; 54 de mães diabéticas; 40 de mães portadoras de imunodeficiência adquirida (HIV); e 140 de mães hígidas. PROCEDIMENTOS: Todos os recém-nascidos tiveram amostras de sangue de cordão umbilical coletadas em papel de filtro ao nascimento. VARIÁVEIS ESTUDADAS: Dosagem de TSH em sangue coletado em papel de filtro usando um ensaio imunofluorométrico próprio (sensibilidade em manchas de sangue seco = 0.1 mU/L). RESULTADOS: Não encontramos diferença na média de TSH dos 5 grupos. Além disso, os níveis de TSH estavam acima de 5 mU/L em 48% dos bebês, sugerindo que nossa região é severamente deficiente em iodo. CONCLUSÕES: Nossos resultados demonstram que programas de detecção precoce de hipotiroidismo congênito, que utilizam primariamente TSH, não são afetados por doenças maternas não-tiroidianas. Sugerimos que, além das vantagens técnicas sobre a punção de calcanhar com dosagem primária de T4, os programas de detecção precoce que utilizam primariamente TSH de cordão umbilical também podem ser usados como instrumento de avaliação e controle da carências de iodo.São Paulo Medical JournalSão Paulo Medical Journal2000-09-09info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://periodicosapm.emnuvens.com.br/spmj/article/view/2684São Paulo Medical Journal; Vol. 118 No. 5 (2000); 144-147São Paulo Medical Journal; v. 118 n. 5 (2000); 144-1471806-9460reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APMenghttps://periodicosapm.emnuvens.com.br/spmj/article/view/2684/2571https://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessWard, Laura SterianKunii, Ilda ShizueMaciel, Rui Monteiro de Barros2023-10-10T13:26:32Zoai:ojs.diagnosticoetratamento.emnuvens.com.br:article/2684Revistahttp://www.scielo.br/spmjPUBhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2023-10-10T13:26:32São Paulo medical journal (Online) - Associação Paulista de Medicinafalse
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