Monitoring of Screening Program for Neonatal Congenital Hypothyroidism in Taif Governorate (KSA)

Background: Congenital hypothyroidism is inadequate thyroid hormone production in newborn infants. This can occur because of an anatomic defect in the gland, an inborn error of thyroid metabolism, or iodine deficiency. Thyroid hormone treatment in children with congenital hypothyroidism can prevent intellectual disability. Guidelines recommend that children with congenital hypothyroidism through newborn screening program remain on treatment till at least 3 years of age, after which a trial off therapy can determine which children have transient hypothyroidism. Objectives: The purpose of this study was to describe the prevalence of congenital hypothyroidism in Taif (KSA) and effect of thyroid hormone treatment in early childhood. Methods: Retrospective analysis of thyroid function of newborns during the period from 1990-2009 was performed. Children were classified as having congenital hypothyroidism based on cord blood screening programme using initial cord blood thyroxine (T4), with supplemental thyrotropin (TSH), and triiodothyronine resin uptake (T3U) measurements. Results: There were a total of 317295 children tested for congenital hypothyroidism. The overall birth prevalence of congenital hypothyroidism was about 1 per 3000. More than one-third of children treated for congenital hypothyroidism discontinued treatment within 36 months, which is inconsistent with current guidelines. Conclusions: The current findings emphasize the critical need for follow-up systems to monitor the outcome of newborn screening. It is not known how many of these children required continued treatment or experienced adverse effects following treatment discontinuation.