Congenital hypothyroidism and the second newborn metabolic screening in Colorado, USA.
OBJECTIVE
To evaluate the effectiveness of a second newborn screening for congenital hypothyroidism (CH).


METHODS
All infants born in Colorado, USA, from July 1996 through June 2004 had a total thyroxine measured with secondary thyroid stimulating hormone determination.


RESULTS
The number of first and second newborn screens completed was 494,324 and 471,877, respectively. The first screen identified 185 cases of CH (incidence of 1:2,703). The second screen identified an additional 42 cases. Overall, the incidence based on both the first and second screenings was 1:2,174. The false negative rate for the first screen was 15.6%. In the absence of a second screen, one infant with CH out of every 11,111 babies screened would have been missed. The addition of the second screen increased the cost-per-case identified from dollars 6,108 to dollars 9,730.


CONCLUSIONS
With only one newborn screen for CH, the number of missed cases is significant and higher than previously reported.
Maniatis
Aristides K
AK
The Children's Hospital of Denver, Department of Endocrinology, University of Colorado Health Sciences Center, CO 80218, USA.
Taylor
Laura
L
Letson
G William
GW
Bloch
Clifford A
CA
Kappy
Michael S
MS
Zeitler
Phil
P
D003120:Colorado / Q000453:epidemiology; D003409:Congenital Hypothyroidism / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D018580:Mandatory Testing / Q000379:methods; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D018709:Statistics, Nonparametric; D013972:Thyrotropin; D013974:Thyroxine / Q000097:blood*; D013975:Thyroxine-Binding Proteins / Q000032:analysis; D014284:Triiodothyronine / Q000097:blood
D013975:Thyroxine-Binding Proteins; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine