Neonatal screening for congenital hypothyroidism in Saudi Arabia: results of screening the first 1 million newborns

Abstract

■ Introduction: Since ihe initiation of pilot screening, programs to detect congenital hypothyroidism (CH) in 1972. newborn screening has become routine in the developed world. A national screening program for CII was established in Saudi Arabia in November. 19S9. Methods: The program utilizes cord serum thyroid stimulating hormone (TSH), tested by the Dellia method, supplemented when necessary with thyroxine <T4) assay, also by the Delfia method. TSH values above 60 mU/1 alone were considered suggestive of CH and initialed recall of the infant. TSH values of .10-60 mU/l initiated T4 measurement. If 'he latter was below SO nmol/l, the infani was also recalled. Results: Between November 1989 and April 1995, a total of 1007 350 infants were screened. The mean recall rate was 0.18% (range 0.05-0.3%). Of those, 306 infants were confirmed to have CH, indicating an incidence for CH in Saudi Arabia of 1:3292. However, a regional variation in incidence was imied. Of all the infant* with congenital hypothyroidism who were adequately studied. 47.5% were found lo have ectopic thyroid glands. 31.7% eutopic glands with increased *9rTc uptake and 20.8% athyreotic. The mean age at the lime of recall was 19.4 days (range 2-130). Ihe average cost of screening was US S3.20 pei specimen. Discussion: Several of the organizational and administrative difficulties which were encountered during the operation were-discussed and solved at regional levels and during the annual general meetings.