title: Congenital hypothyroidism screening program in iran; a systematic review and metaanalysis.
abstract: OBJECTIVE
  Unrecognized congenital hypothyroidism (CH) leads to mental retardation. Newborn screening and thyroid therapy started within 2 weeks of age can normalize cognitive development. In this systematic review, the local results of the national CH screening program in different provinces in Iran are reviewed and evaluated.
  
  
  METHODS
  Literature on the CH screening, the national databases including SID, Medlib, Iran Medex, Magiran as well as international databases including PubMed/Medline, ISI Web of Knowledge and web of science, EMBASE, SCOPUS and Google Scholar. Appraisal was guided by a checklist assessing clarity of aims and research questions. The 95% confidence intervals were calculated by I-square models. Meta regression was introduced to explore the heterogeneity between studies.
  
  
  RESULTS
  We identified 25 samples including 1425124 neonates in our country. Data were Meta analyzed using random-effects models, and we found a TSH levels of 19633 babies in the first sampling were greater than the cut-off level (TSH ≥5mIU/L). The pooled recall rate was 0.014 (95 % CI: 0.013 - 0.015). According to Meta analysis the overall incidence of CH was 2/1000 (95% CI: .002 - .002). The incidence of CH did not appear to be increasing over time (P=0.08).
  
  
  CONCLUSIONS
  Considering TSH ≥5mIU/L as a cut-off point for recalling neonates and low positive predictive value (14%) of this point shows that more investigation and research is needed for establishing accurate level of TSH as a criterion for recalling patients.
authors.affiliation: Student Research Committee.
authors.forename: Yousef
authors.initials: Y
authors.lastname: Veisani
authors.affiliation: Prevention of Psychosocial Injuries Research Centre, Ilam University of Medical Sciences, Ilam.
authors.forename: Kourosh
authors.initials: K
authors.lastname: Sayehmiri
authors.affiliation: Department of Epidemiology, School of Health, Shiraz University of Medical Sciences.
authors.forename: Shahab
authors.initials: S
authors.lastname: Rezaeian
authors.affiliation: Department of Clinical Epidemiology, Ilam University of Medical Sciences, Ilam, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Delpisheh
keywords: Congenital; Congenital Hypothyroidism; Hypothyroidism; Iran; Meta Regression