Congenital Hypothyroidism in Newborn in 4 Regions of Thailand during the Period from 2016 to 2018

Main Article Content

Piamnukul Krasao
Penpan Thong-ngao
Jaranee Phoungphosop
Wiyada Charoensiriwatana
Hansa Thaisri
Archawin Rojanawiwat


          Congenital hypothyroidism (CHT) is caused by thyroid hormone deficiency in newborn which leads to mental and growth retardation. Clinical symptoms do not manifest at birth. Neonatal screening for CHT is therefore necessary and made possible of the affected neonates to get early diagnosis and treatment in time. CHT newborn screening was determined by measuring thyroid stimulating hormone (TSH) from dried blood spot sample (DBS). The heel prick samples (whole blood) were collected on filter papers from newborns at age more than 48 hours after birth and the enzyme-linked immunosorbent assay (ELISA) technique has been used as screening test for CHT. From 2016 to 2018, a total of 1,610,479 Thai newborns had been screened for CHT and 830 newborns were found to be CHT, while the incidence of CHT was about 5.15 per 10,000 screened newborn. As compared with the CHT screening in the 4 regions of Thailand: Central, North, Northeast and South, the samples had coverage of about 97.65%, 99.87%, 97.52% and 80.92%, respectively. It was found that the incidences of CHT in the 4 regions were 5.01, 6.22, 5.60 and 3.52 per 10,000 screened newborns, respectively. As can be seen, the highest incidence of CHT was found in the northern region of Thailand whereas the lowest was found in the southern region. Furthermore, 51.49% of the screened newborns were boys and 4.92% was preterm infants. From confirmation of the follow-up samples, it was found that the incidence rate of the confirmed screening in girls was greater than boys and preterm infant was greater than in term of infant. The CHT incidence rate has increased over the year in all regions of Thailand.


Download data is not yet available.

Article Details

Original Articles


1. Nagasaki K, Minamitani K, Anzo M, Adachi M, Ishii T, Onigata K, et al. Guidelines for mass screening of congenital hypothyroidism (2014 revision). Clin Pediatr Endocrinol 2015; 24(3): 107-33.

2. LaFranchi SH. Worldwide coverage of newborn screening for congenital hypothyroidism - a public health challenge. US Endocrinol 2014; 10(2): 115-6.

3. Rastogi MV, LaFranchi SH. Congenital hypothyroidism. Orphanet J Rare Dis 2010; 5: 17. (22 pages).

4. Yarahmadi SH, Tabibi SJ, Alimohammadzadeh KH, Ainy E, Gooya MM, Mojarrad M, et al. Cost-benefi t and eff ectiveness of newborn screening of congenital hypothyroidism: fi ndings from a national program in Iran. Int J Endocrinol Metab 2010; 8(1): 1-6.

5. Therrell BL, David-Padilla C. Screening of newborns for congenital hypothyroidism: guidance for developing programmes. Vienna: International Atomic Energy Agency, 2005.

6. Buyukgebiz A. Newborn screening for congenital hypothyroidism. J Clin Res Pediatr Endocrinol 2013; 5 (Suppl 1): 8-12.

7. Mehran L, Khalili D, Yarahmadi S, Amouzegar A, Mojarrad M, Ajang N, et al. Worldwide recall rate in newborn screening programs for congenital hypothyroidism. Int J Endocrinol Metab 2017; 15(3): e55451. (12 pages).

8. Ford G, LaFranchi SH. Screening for congenital hypothyroidism: a worldwide view of strategies. Best Pract Res Clin Endocrinol Metab 2014; 28(2): 175-87.

9. LaFranchi SH. Increasing incidence of congenital hypothyroidism: some answers, more questions. J Ciln Endocrinol Metab 2011; 96(8): 2395-7.

10. McGrath N, Hawkes CP, McDonnell CM, Cody D, O'Connell SM, Mayne PD, et al. Incidence of congenital hypothyroidism over 37 years in Ireland. Pediatrics 2018; 142(4): e20181199. (10 pages).

11. Deng K, He C, Zhu J, Liang J, Li X, Xie X, et al. Incidence of congenital hypothyroidism in China: data from the national newborn screening program, 2013-2015. J Pediatr Endocrinol Metab 2018; 31(6): 601-8.

12. Heather NL, Derraik JGB, Webster D, Hofman PL. The impact of demographic factors on newborn TSH levels and congenital hypothyroidism screening. Clin Endocrinol (Oxf) 2019; 91(3): 456-63.

13. Hinton CF, Harris KB, Borgfeld L, Drummond-Borg M, Eaton R, Lorey F, et al. Trends in incidence rates of congenital hypothyroidism related to select demographic factors: data from the United States, California, Massachusetts, New York and Texas. Pediatrics 2010; 125 (Suppl 2): S37-47.

14. Charoensiriwatana W, Janejai N, Boonwanich W, Krasao P, Chaisomchit S, Waiyasilp S. Neonatal screening program in Thailand. Southeast Asian J Trop Med Public Health 2003; 34(suppl 3): 94-100.

15. Zimmermann MB. The eff ects of iodine defi ciency in pregnancy and infancy. Paediatr Perinat Epidemiol 2012; 26 (Suppl 1): 108-17.

16. Aguayo A, Grau G, Vela A, Aniel-Quiroga A, Espada M, Martul P, et al. Urinary iodine and thyroid function in a population of healthy pregnant woman in the North of Spain. J Trace Elem Med Biol 2013; 27(4): 302-6.

17. Siberry GK, Iannone R. The Harriet Lane handbook: a manual for pediatric house offi cers. 15th ed. St. Louis: Mosby; 2000. p. 219.

18. ศูนย์ปฏิบัติการตรวจคัดกรองสุขภาพทารกแรกเกิดแห่งชาติ กรมวิทยาศาสตร์การแพทย์. แนวทางในการวินิจฉัยภาวะพร่องฮอร์โมนไทรอยด์แต่กำเนิด. [ออนไลน์]. 2559; [สืบค้น 12 เม.ย. 2560]; [2 หน้า]. เข้าถึงได้จาก: URL:

19. กองยุทธศาสตร์และแผนงาน สำนักงานปลัดกระทรวงสาธารณสุข. สถิติสาธารณสุข พ.ศ. 2561. นนทบุรี: กระทรวงสาธารณสุข; 2562.

20. Niwa F, Kawai M, Kanazawa H, Iwanaga K, Matsukura T, Hasegawa T, et al. Hyperthyrotropinemia at 2 weeks of age indicates thyroid dysfunction and predicts the occurrence of delayed elevation of thyrotropin in very low birth weight infants. Clin Endocrinol (Oxf) 2012; 77(2): 255-61.

21. McGrath N, Hawkes CP, Mayne P, Murphy NP. Optimal timing of repeat newborn screening for congenital hypothyroidism in preterm infants to detect delayed thyroid-stimulating hormone elevation. J Pediatr 2019; 205: 77-82.

22. Kaluarachchi DC, Allen DB, Eickhoff JC, Dawe SJ, Baker MW. Increased congenita hypothyroidism detection in preterm infants with serial newborn screening. J Pediatr 2019; 207: 220-5.