1. Trends in Scottish newborn screening programme for congenital hypothyroidism 1980–2014: strategies for reducing age at notification after initial and repeat sampling
- Author
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Sarah Smith, Moira Fitch, Malcolm Donaldson, Jeremy Jones, Chourouk Mansour, Yasmine Ouarezki, and Avril Mason
- Subjects
Pediatrics ,medicine.medical_specialty ,Thyroid screening ,Thyrotropin ,030209 endocrinology & metabolism ,free thyroxine ,Guthrie sample ,Specimen Handling ,03 medical and health sciences ,0302 clinical medicine ,Age Distribution ,Neonatal Screening ,030225 pediatrics ,capillary thyroid stimulating hormone ,medicine ,Humans ,Sampling (medicine) ,Newborn screening ,business.industry ,Infant, Newborn ,congenital hypothyroidism ,Free thyroxine ,medicine.disease ,Congenital hypothyroidism ,Thyroxine ,Scotland ,Laboratory reporting ,Pediatrics, Perinatology and Child Health ,Electronic transmission ,Age distribution ,Original Article ,notification ,business ,Newborn Screening - Abstract
Objectives: To determine ages at first capillary sampling and notification and age at notification after second sampling in Scottish newborns referred with elevated thyroid-stimulating hormone (TSH).\ud \ud Subjects and methods: Referrals between 1980 and 2014 inclusive were grouped into seven 5-year blocks and analysed according to agreed standards.\ud \ud Results: Of 2 116 132 newborn infants screened, 919 were referred with capillary TSH elevation ≥8 mU/L of whom 624 had definite (606) or probable (18) congenital hypothyroidism. Median age at first sampling fell from 7 to 5 days between 1980 and 2014 (standard 4–7 days), with 22, 8 and 3 infants sampled >7 days during 2000–2004, 2005–2009 and 2010–2014. Median age at notification was consistently ≤14 days, range falling during 2000–2004, 2005–2009 and 2010–2014 from 6 to 78, 7–52 and 7–32 days with 12 (14.6%), 6 (5.6%) and 5 (4.3%) infants notified >14 days. However 18/123 (14.6%) of infants undergoing second sampling from 2000 onwards breached the ≤26-day standard for notification. By 2010–2014, the 91 infants with confirmed congenital hypothyroidism had shown favourable median age at first sample (5 days) with start of treatment (10.5 days) approaching age at notification.\ud \ud Conclusion: Most standards for newborn thyroid screening are being met by the Scottish programme, but there is a need to reduce age range at notification, particularly following second sampling. Strategies to improve screening performance include carrying out initial capillary sampling as close to 96 hours as possible; introducing 6-day laboratory reporting and use of electronic transmission for communicating repeat requests.
- Published
- 2017