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WHY IT IS IMPORTANT TO SCREEN FOR CONGENITAL HYPOTHYROIDISM

Diet Sadiah Rustama

National Working Group for Neonatal Screening, Ministry of Health

Abstract
Thyroid hormone (TH) has an essential role in the brain development during the first 2 – 3
year of life. 1Thyroid hormone is essential for adequate development of very specific
neuropsychological functions and, when TH is insufficent, these fucntions are imppaired.2
Congenital hypothroidism (CH) represent one of the most common preventable causes of
mental retardation. Obvious manifestations of hypothyroidism are not typically presentat
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 family3 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 era4. CH has been broadly classified as
primary (thyroid glad dysfunction) and secondary ( pituitary gland dysfunction,
permanentand transient types, and syndromic. The most common form of CH is primary
hypothyroidism. Whatever the etiology, CH result in significant loss of productivity.5 The
prevention of neurological deficits through the early initiation of treatment during the
neonatal period is one of the chief justificationsfor the screening of newborns and has greatly
modified prognosis6. The goalof newborn screening is to detect CH and begin treatment
before theinfant reaches one moth of age Treatment is simple, inexpensive, and effective.
With early detection and treatment, infants usually develop normally without mental
handicaps and become productive members of society.7Screening for primary CH worlwide
should be performed whereverpossible 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 hypthyroidism, newborn screening