WHY IT IS IMPORTANT TO SCREEN FOR CONGENITAL HYPOTHYROIDISM

Diet Sadiah Rustama

National Working Group for Neonatal Screening

Abstract
Thyroid hormone (TH) has an essential role in the brain development during the first 2 – 3
year of life ; It is essential for adequate development of very specific neuropsychological
functions and, when TH is insufficient, these functions are impaired. Congenital
hypothyroidism (CH) represent one of the most common preventable causes of mental
retardation. Obvious manifestations of hypothyroidism are not typically present at birth,
meaning that clinical diagnosis is usually delayed until 3 months of age or older.
Unfortunately, by the time the diagnosis is suspected, the effects of thyroid deficiency on the
developing brain are irreversible, resulting unnecessary health, economic, and social burdens
for the family Estimates of the prevalence of CH vary according to the method of
ascertainment : about 1 in 2000 to 3000 live births in countries with neonatal screening vs
about 1 in 6700 live births before the screening era. CH has been broadly classified as
primary (thyroid gland dysfunction) and secondary (pituitary gland dysfunction), permanent
and transient types, and syndromic. The most common form of CH is primary
hypothyroidism. Whatever the etiology, CH result in significant loss of productivity The
prevention of neurological deficits through the early initiation of treatment during the
neonatal period is one of the chief justifications for the screening of newborns and has greatly
modified prognosis. The goal of newborn screening is to detect CH and begin treatment
before the infant reaches one month of age. Treatment is simple, inexpensive, and effective.
With early detectin and treatment, infants usually develop normally without mental handicaps
and become productive members of society. Screening for primary CH worldwide should be
performed wherever possible on the basis of national resources In ensuring The United
Nations Convention on The Right of the Child and The Child Protection Law , the screening
of the newborns, in this regard, is a major step forward in primary health care for all children
: it is a compelling argument that can serve to persuade the government policy makers of the
need and benefits of newborn sreening

Keywords : Congenital hypothyroidism, newborn screening