Cord blood thyroid-stimulating hormone and free T4 levels in Turkish neonates: is iodine deficiency still a continuing problem?
BACKGROUND
The objectives of this study were to determine the cord blood thyroid-stimulating hormone (TSH) and free T(4) (FT(4) ) levels in Turkish neonates and to determine whether these variables reveal iodine deficiency.


METHODS
We collected 818 cords from healthy mothers at parturition and measured levels of FT(4) and TSH. We also measured cord blood FT(4) and TSH levels in different stages of gestation and gender. We grouped the neonates according to cord serum TSH levels, either being less (Group A) or greater (Group B) than 10 mIU/L. Group A included 589 neonates (300 girls [51%] and 289 boys [49%]) and Group B included 229 neonates (105 girls [45%] and 124 boys [55%]).


RESULTS
The percentage of subjects with cord blood TSH < 10 mIU/L and >10 mIU/L was 72% and 28%, respectively. Although cord TSH levels in Group B were greater than those in Group A (P < 0.001), cord blood FT(4) levels in Group B were lower than those in Group A (P < 0.05). There was no difference between both sex in terms of birthweight and maternal age. TSH and FT(4) levels did not vary according to neonate sex during gestation, except for from week 37 to 41. TSH levels of male neonates at the 41st week of gestation were higher than those of female neonates (P < 0.05). There were no effects of birthweight on TSH and FT(4) levels if the neonate was lighter than 2500 g at birth. TSH levels of male neonates were higher than those of female neonates when their birthweights were <2500 g (P < 0.05). There was no significant difference in TSH levels according to birthweights in male neonates.


CONCLUSIONS
Our data provide the normative data for cord blood TSH and FT(4) levels in Turkish neonates and show that iodine deficiency is a still a public health problem in Turkey. These measurements can be useful for detection and verification of hypothyroidism in a screening program for congenital hypothyroidism as well as evaluation of the success of the iodination program.
Kişlal
Fatih
F
Clinic of Neonatology, Dr Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
Cetinkaya
Semra
S
Dilmen
Uğur
U
Yaşar
Handan
H
Teziç
Tahsin
T
D000293:Adolescent; D000328:Adult; D003409:Congenital Hypothyroidism / Q000175:diagnosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003677:Deficiency Diseases / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005312:Fetal Blood / Q000737:chemistry / Q000378:metabolism*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007455:Iodine / Q000172:deficiency*; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D015997:Neonatal Screening; D011247:Pregnancy; D011322:Primary Prevention / Q000379:methods; D018570:Risk Assessment; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood* / Q000172:deficiency; D013974:Thyroxine / Q000097:blood*; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
D013972:Thyrotropin; D007455:Iodine; D013974:Thyroxine