Cord blood thyroid stimulating hormone level - and the influence of perinatal and other factors on it

ORIGINAL ARTICLE

Cord blood Thyroid Stimulating Hormone Level - and the influence of perinatal and other factors on it

Subhash Poyekar¹, Shilpa Pratinidhi², Swapnil S Prasad³, Zainab S Sardar³, Bhavesh Kankariya³, Om Bhole³.

¹Department of Paediatrics, Rural Medical College, Loni, Maharashtra, India,
²Department of Biochemistry, MIMER Medical College, Talegaon-Dabhade, Maharashtra, India,
³MIMER Medical College, Talegaon-Dabhade, Maharashtra, India.

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Abstract
Background: Thyroid hormone is essential for growth and development especially the brain. Deficiency of thyroid hormone i.e. congenital hypothyroidism (CH) is the commonest cause of preventable mental retardation. As it is difficult to diagnose CH with clinical symptoms at birth, most patients with CH are diagnosed by laboratory results. Early detection is important, either by Thyroid Stimulating Hormone (TSH) or T4 estimation or both by newborn screening. Cord blood TSH (CB-TSH) estimation has high sensitivity, but various maternal and perinatal factors affect the CB-TSH levels, which may interfere with the interpretation.
Aim: This study was done to find out the various maternal and perinatal factors affecting CB-TSH level.
Materials and Methods: A hospital-based cross-sectional study was conducted in the Department of Paediatrics, Obstetrics and Biochemistry of Medical College, Pune over a period of one and half year. Cord blood TSH level was estimated and the results were statistically analysed with respect to various maternal and perinatal factors. A TSH cut-off of >20 µIU/mL was considered as high.
Result: A total number of 726 newborns were enrolled in the study. The mean CB-TSH was 8.9 µIU/mL with 54 (7.5%) newborns having values more than 20 µIU/mL. CB-TSH was significantly raised in male babies, in first order neonates delivered by vaginal delivery. Neonates who had fetal distress or non-progress of labour had significantly higher CB-TSH than those who were delivered by elective caesarean section. Gestational age and birth weight of newborns did not have influence on CB-TSH.
Conclusion: About 7.5% newborns had elevated CB-TSH levels. Gender of the baby, perinatal stress factors and mode of delivery have significant relationship with the CB-TSH level. Hence, due consideration should be given to these factors while interpreting CB-TSH levels.

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