The Study Of Newborn Congenital Hypothyroidism Screening In SuZhou From 1999 To 2013

ObjectiveCongenital hypothyroidism(CH) is a common endocrine disease in children. Analysis of newborn congenital hypothyroidism screening in SuZhou from 1999 to 2013,which has five countries and five districts. Through the investigation and analysis we try to look for relevant risk factors, provide guidance of the treatment of congenital hypothyroidism in SuZhou area and provide data for further study of SuZhou area.MethodUsing the method of retrospective investigation,794851 cases of newborn congenital hypothyroidism screening in SuZhou from 1999 to 2013 related statements descriptive analysis and case information and statistical inference.Tnvestigation and detection methods:adopting the time-resolved fluorescence immunoassay (TRFIA) in the detection of neonatal serum thyroid stimulation hormone(TSH) value,to recall in venous blood of children with abnormal values by chemiluminescence method to detect serum T3,T4and TSH concentrations.The chrild whose serum TSH was higher than nomal,T3,FT4 below the nomal,was diagnosed of Congenital hypothyroidism.86 pregnant women were randomly selected as the case group,who have the results of thyroid function at the first time giving birth check (gestational three months) and have deliveryed a baby with CH; 200 pregnant women were randomly selected as the contral group,who have the results of thyroid function at the first time giving birth check (gestational three months) but have deliveryed the healthy a baby without CH. The results of TSH and TPOAb of two groups were compared for statistical analysis.Results1. At Suzhou region in 1999-2013,794851 cases of neonatal screening for CH,461 cases were confirmed CH,and the positive rate of 1:1724,compared with the incidence of 1/2047 of the nationa is slightly higher.2.207 cases male,254 cases female(1/2040),male female ratio(1/1467) is about 1 to 1.39 (P<0.001)3. TO compare the incidence of SuZhou different countries and districts,SuZhou industrial park of incidence of CH is higher than other counties, with statistical significance (P<0.05)4. Since 1999, the incidence of CH appeared rising trend, incidence of nearly three years to stabilize. Using the statistical software analysis, the incidence of CH has obvious seasonal correlation, fall below the winter spring, with statistical differences (P<0.05)5.393 cases of children finished 2 years of follow-up, and emporary CH to permanent CH for 138:255; boy temporary CH to boy total CH for 74/186 (39.9%); girl temporary CH to girl total CH for 64/207(30.9%), which has statistical differences (P<0.001)6.2 years of follow-up, in children with thyroid dysplasia of children with CH 76:393 (19.3%). Temporarily CH has no thyroid dysplasia in thyroid dysplasia, permanent CH 255 cases,77 cases of thyroid dysplasia, accounted for 77/255 (30.1%).30 cases of the permanent CH with other system malformation, in the total 255 permanent CH. Temporary CH with other system malformation had 2 cases, accounting for 2/138 of the temporary CH. Permanent thyroid function reduces the incidence of congenital malformation in the disease increased, the gap has a statistical difference.7. TSH>43.4 ulU/ml of congenital hypothyroidism outcome for permanent CH possibility.Through the ROC analysis we get the sensitiveness is 77.3% and the specificity is 84.8%. TG significantly decreased and increased significantly in judging the prognosis of congenital hypothyroidism as permanent CH has certain significance.Conclusion1. The incidence of the CH in Suzhou(1:1724) area is above the national.2. The incidence of suzhou area increased from 1999 to 2010, the highest incidence rates in 2010. In the three years,2011-2013, gradually stable.3. The incidence of the five countries and five districts.area in Suzhou, suzhou industrial park, the highest incidence.4. The incidence of male is lower than the female, the difference has statistical significance.5. Female, abnormal thyroid gland development, associated with other congenital malformation is an increased risk for permanent thyroid function decrease sickness. Maternal thyroid function abnormalities may be associated with CH.6. TSH>43.4 uIU/ml of congenital hypothyroidism outcome for permanent hypothyroidism possibility. TG significantly decreased and increased significantly in judging the prognosis of congenital hypothyroidism has certain significance.