• L S Ward, I S Kunii, and R M de Barros Maciel.
• Department of Medicine, Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil.
• Sao Paulo Med J. 2000 Sep 7; 118 (5): 144147144-7.

ContextScreening programs not only offer the opportunity to trace and treat almost all cases of congenital hypothyroidism but also mean large savings to the health system. However, carefully planned strategies are necessary to extend their benefits and reduce costs.ObjectiveTo determine the possible influence of maternal diseases that affect maternal-fetal placenta dynamics on primary thyroid stimulating hormone (TSH) screening for congenital hypothyroidism.DesignProspective non-randomized clinical trial with at least 3 months of follow-up.SettingA public university referral center [CAISM/Hospital das Clínicas, Faculty of Medicine, University of Campinas, Campinas, SP].Participants415 neonates divided into 5 groups: eighty-three infants born from cardiac mothers; 98 from mothers that had toxemia; 54 of the mothers had diabetes mellitus; 40 were HIV positive and 140 had no diseases.InterventionAll newborns had cord blood samples collected on filter paper at birth.Main MeasurementsTSH was measured from dried blood spots using a homemade immunofluorescence assay (sensitivity in dried blood spots = 0.1 mU/L).ResultsThere was no significant difference in the mean TSH levels among the 5 groups. Moreover, TSH levels were around 5 mU/L in 48% of the newborns, indicating that our region is severely deficient in iodine.ConclusionsOur results indicate that primary TSH screening programs using cord blood are not affected by maternal diseases. We suggest that, besides its technical advantages over heel punctures with T4 primary approaches, neonatal screening using primary cord blood TSH may also be used as a monitoring tool for evaluation and control of iodine deficiency disorders (IDD).

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