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Comparison of neonatal thyroid-stimulating hormone levels and indicators of iodine deficiency in school children

Published online by Cambridge University Press:  02 January 2007

Daphne L Copeland ,
Kevin M Sullivan ,
Robin Houston ,
Warwick May ,
Ivan Mendoza ,
Quazi Salamatullah ,
Noel Solomons ,
Dale Nordenberg  and
Glen F Maberly
Daphne L Copeland
Affiliation:
Rollins School of Public Health of Emory University, and the Program Against Micronutrient Malnutrition (PAMM), Department of Epidemiology,1518 Clifton Road NE,Atlanta,GA 30322, USA
Kevin M Sullivan*
Affiliation:
Rollins School of Public Health of Emory University, and the Program Against Micronutrient Malnutrition (PAMM), Department of Epidemiology,1518 Clifton Road NE,Atlanta,GA 30322, USA
Robin Houston
Affiliation:
Rollins School of Public Health of Emory University, and the Program Against Micronutrient Malnutrition (PAMM), Department of Epidemiology,1518 Clifton Road NE,Atlanta,GA 30322, USA Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
Warwick May
Affiliation:
Rollins School of Public Health of Emory University, and the Program Against Micronutrient Malnutrition (PAMM), Department of Epidemiology,1518 Clifton Road NE,Atlanta,GA 30322, USA
Ivan Mendoza
Affiliation:
Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Guatemala City, Guatemala
Quazi Salamatullah
Affiliation:
Institute of Nutrition and Food Science, Dhaka University, Dhaka, Bangladesh
Noel Solomons
Affiliation:
Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Guatemala City, Guatemala
Dale Nordenberg
Affiliation:
Rollins School of Public Health of Emory University, and the Program Against Micronutrient Malnutrition (PAMM), Department of Epidemiology,1518 Clifton Road NE,Atlanta,GA 30322, USA
Glen F Maberly
Affiliation:
Rollins School of Public Health of Emory University, and the Program Against Micronutrient Malnutrition (PAMM), Department of Epidemiology,1518 Clifton Road NE,Atlanta,GA 30322, USA
*
*Corresponding author: Email [email protected]
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Abstract

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Objectives:

To compare thyroid-stimulating hormone (TSH) levels in neonatal cord blood between study sites in Bangladesh, Guatemala and the United States. Also, to compare neonatal TSH results with indicators of iodine deficiency in school children.

Design:

Consecutive births and, in school children, cross-sectional surveys.

Setting:

Savar, Bangladesh; San Pedro Sacatepequez, Guatemala; and Atlanta, United States.

Subjects:

In each study site, cord blood was spotted on to filter paper and TSH levels determined using a sensitive monoclonal assay. In the USA, heel stick blood specimens from newborns spotted on to filter paper were also obtained as well as exposure to iodine-containing antiseptics during the birthing process. Urine specimens were collected from mothers of newborns and tested for iodine concentration. School children in the same areas were surveyed for thyroid size by palpation and ultrasonography, and urine specimens collected for iodine concentration.

Results:

Between 141 and 243 cord blood specimens were collected from each study site. The prevalence of elevated cord blood TSH levels (>5 mU l−1) was high in all study sites, from 58% to 84%. All sites would be categorised as having ‘severe’ iodine deficiency based on WHO/UNICEF/ICCIDD criteria. Iodine-containing antiseptics were used during 98% of the births in the USA but not in Bangladesh or Guatemala. The neonatal TSH classification indicated more severe iodine deficiency levels than classifications based on urinary iodine and goitre in school children.

Conclusions:

In the USA, elevated TSH levels may be partially attributed to use of beta-iodine-containing antiseptics prior to birth. We recommend the cautious interpretation of TSH results in newborns for the assessment of iodine deficiency disorders when iodine-containing antiseptics are used during the birthing process.

Keywords

Iodine deficiencyThyroid-stimulating hormoneUrinary iodineGoitreNeonatal screeningHumansNewborns
Type
Research Article
Information
Public Health Nutrition , Volume 5 , Issue 1 , February 2002 , pp. 81 - 87
Copyright
Copyright © CABI Publishing 2002

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