Skip to main content
Article
Licensed
Unlicensed Requires Authentication

Incidence and associated risk factors of congenital hypothyroidism among newborns in Hainan, China: a retrospective study

  • ORCID logo , , and EMAIL logo
Published/Copyright: June 25, 2024
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 37 Issue 8

Abstract

Objectives

This study aims to investigate the incidence and risk factors of congenital hypothyroidism (CH) in newborns in Hainan Province, China, to provide a reference for early and effective prevention strategies.

Methods

Newborns born in Hainan Province from 2017 to 2021 were the subjects of this study. Time-resolved immunofluorescence was used for initial screening and chemiluminescence for confirmatory diagnosis. Based on the diagnosis, newborns were classified into CH and non-CH groups. Statistical analysis was conducted on the initial screening and confirmed CH cases in newborns in Hainan Province, and potential risk factors for CH were explored.

Results

From 2017 to 2021, a total of 585,886 newborns were screened, revealing 6,856 initial positive results, 614 positive rescreens, and 420 confirmed CH cases, yielding an incidence rate of 1/1,395 (420/585,886). The annual initial positive screening rate of newborns in Hainan Province showed a rising trend from 2017 to 2021 (p=0.000). No significant differences were found regarding gender (p=0.400) and ethnicity (p=0.836). Multivariate logistic regression analysis indicated that residing in coastal areas, especially those with salt fields (OR=2.151, 95 % CI: 1.364–3.390), was risk factors for the development of CH in newborns.

Conclusions

The incidence of CH in newborns showed a year-on-year increase in Hainan Province from 2017 to 2021. Residing in coastal areas, particularly those with salt fields, was identified as a risk factor for the development of CH.

Keywords: congenital hypothyroidism; newborn; incidence; risk factor; newborn screening
Corresponding author: Haizhu Xu, Newborn Disease Screening Center, Hainan Women and Children’s Medical Center, Haikou 570206, China, E-mail:
Zhendong Zhao and Haijie Shi contributed equally to this work.

Funding source: Project Supported by Hainan Province Clinical Medical Center

Award Identifier / Grant number: QWYH202175

Funding source: Hainan Health Science and Technology Innovation Joint Project Fund

Award Identifier / Grant number: WSJK2024MS174

Funding source: Health Industry Project of Hainan Province

Award Identifier / Grant number: 22A200094

  1. Research ethics: Ethical approval was obtained from the Ethics Committee of Hainan Women and Children’s Medical Center [HNWCMC 2022 No. (71)]. The authors confirm that the manuscript has been submitted solely to this journal and is not published, in press, or submitted elsewhere.

  2. Informed consent: Informed consent was obtained from all individuals included in this study, or their legal guardians or wards.

  3. Author contributions: Zhendong ZHAO and Haijie SHI: Substantial contributions to the conception or design of the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy. Haizhu XU: Substantial contributions to the conception or design of the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published. Yingmei WEN: Substantial contributions to the acquisition, analysis, and interpretation of data for the work. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Competing interests: The authors state no conflict of interest.

  5. Research funding: This study was supported by the Hainan Health Science and Technology Innovation Joint Project Fund (WSJK2024MS174), the Health Industry Project of Hainan Province (22A200094), and the Project Supported by Hainan Province Clinical Medical Center(QWYH202175).

  6. Data availability: The raw data can be obtained on request from the corresponding author.

References

1. Rose, SR, Wassner, AJ, Wintergerst, KA, Yayah-Jones, NH, Hopkin, RJ, Chuang, J, et al.. Congenital hypothyroidism: screening and management. Pediatrics 2023;151. https://doi.org/10.1542/peds.2022-060420.Search in Google Scholar PubMed

2. Bowden, SA, Goldis, M. Congenital hypothyroidism. 2023 Jun 5. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024.Search in Google Scholar

3. Liu, L, He, W, Zhu, J, Deng, K, Tan, H, Xiang, L, et al.. Global prevalence of congenital hypothyroidism among neonates from 1969 to 2020: a systematic review and meta-analysis. Eur J Pediatr 2023;182:2957–65. https://doi.org/10.1007/s00431-023-04932-2.Search in Google Scholar PubMed

4. Yao, YN, Yuan, XL, Zhu, J, Xiang, LC, Li, Q, Deng, K, et al.. Geographic variations in the incidence of congenital hypothyroidism in China: a retrospective study based on 92 million newborns screened in 2013–2018. Chin Med J 2021;134:2223–30. https://doi.org/10.1097/cm9.0000000000001613.Search in Google Scholar PubMed PubMed Central

5. Zhong, K, Shi, H, Wu, W, Xu, H, Wang, H, Zhao, Z. Genotypic spectrum of alpha-thalassemia and beta-thalassemia in newborns of the Li minority in Hainan province, China. Front Pediatr 2023;11:1139387.10.3389/fped.2023.1139387Search in Google Scholar PubMed PubMed Central

6. Darrat, M, Kayes, L, Woodside, JV, Mullan, K, Abid, N. Congenital hypothyroidism in Northern Ireland: 40 years’ experience of national screening programme. Clin Endocrinol 2023;99:409–16. https://doi.org/10.1111/cen.14940.Search in Google Scholar PubMed

7. Boelen, A, Zwaveling-Soonawala, N, Heijboer, AC, van Trotsenburg, ASP. Neonatal screening for primary and central congenital hypothyroidism: is it time to go Dutch? Eur Thyroid J 2023;12:e230041. https://doi.org/10.1530/etj-23-0041.Search in Google Scholar

8. Van Vliet, G, Grosse, SD. Newborn screening for congenital hypothyroidism and congenital adrenal hyperplasia: benefits and costs of a successful public health program. Med Sci 2021;37:528–34. https://doi.org/10.1051/medsci/2021053.Search in Google Scholar PubMed PubMed Central

9. Zhong, Z, Liu, X, Huang, C, Xu, H, Fu, C. Variants of the phenylalanine hydroxylase gene in neonates with phenylketonuria in Hainan, China. Scand J Clin Lab Invest 2020;80:619–22.10.1080/00365513.2020.1827287Search in Google Scholar PubMed

10. Lüders, A, Blankenstein, O, Brockow, I, Ensenauer, R, Lindner, M, Schulze, A, et al.. Neonatal screening for congenital metabolic and endocrine disorders–results from Germany for the years 2006–2018. Dtsch Arztebl Int 2021;118:101–8. https://doi.org/10.3238/arztebl.m2021.0009.Search in Google Scholar PubMed PubMed Central

11. Huynh, T, Greaves, R, Mawad, N, Greed, L, Wotton, T, Wiley, V, et al.. Fifty years of newborn screening for congenital hypothyroidism: current status in Australasia and the case for harmonisation. Clin Chem Lab Med 2022;60:1551–61. https://doi.org/10.1515/cclm-2022-0403.Search in Google Scholar PubMed

12. Anne, RP, Rahiman, EA. Congenital hypothyroidism in India: a systematic review and meta-analysis of prevalence, screen positivity rates, and etiology. Lancet Reg Health Southeast Asia 2022;5:100040. https://doi.org/10.1016/j.lansea.2022.100040.Search in Google Scholar PubMed PubMed Central

13. Yarahmadi, S, Azhang, N, Nikkhoo, B, Rahmani, K. A success story: review of the implementation and achievements of the national newborn screening program for congenital hypothyroidism in Iran. Int J Endocrinol Metab 2020;18:e99099. https://doi.org/10.5812/ijem.99099.Search in Google Scholar PubMed PubMed Central

14. Minamitani, K. Newborn screening for congenital hypothyroidism in Japan. Int J Neonatal Screen 2021;7:34. https://doi.org/10.3390/ijns7030034.Search in Google Scholar PubMed PubMed Central

15. Yu, A, Alder, N, Lain, SJ, Wiley, V, Nassar, N, Jack, M. Outcomes of lowered newborn screening thresholds for congenital hypothyroidism. J Paediatr Child Health 2023;59:955–61. https://doi.org/10.1111/jpc.16425.Search in Google Scholar PubMed

16. Lain, S, Trumpff, C, Grosse, SD, Olivieri, A, Van Vliet, G. Are lower TSH cutoffs in neonatal screening for congenital hypothyroidism warranted? Eur J Endocrinol 2017;177:D1–12. https://doi.org/10.1530/eje-17-0107.Search in Google Scholar PubMed PubMed Central

17. Gmür, S, Konrad, D, Fingerhut, R. Prevalence of transient hypothyroidism in children diagnosed with congenital hypothyroidism between 2000 and 2016. Int J Mol Sci 2023;24:2817. https://doi.org/10.3390/ijms24032817.Search in Google Scholar PubMed PubMed Central

18. Abbasi, R, Harari-Kremer, R, Haim, A, Raz, R. Risk factors of congenital hypothyroidism in Israel. Isr Med Assoc J 2022;25:808–14.Search in Google Scholar

19. Hakim, A. Investigation of risk factors of congenital hypothyroidism in children in southwestern Iran. Glob Pediatr Health 2022;9. https://doi.org/10.1177/2333794x221089764.Search in Google Scholar

20. Carlsen, MH, Andersen, LF, Dahl, L, Norberg, N, Hjartåker, A. New iodine food composition database and updated calculations of iodine intake among Norwegians. Nutrients 2018;10:930. https://doi.org/10.3390/nu10070930.Search in Google Scholar PubMed PubMed Central

21. Nagasaki, K, Minamitani, K, Nakamura, A, Kobayashi, H, Numakura, C, Itoh, M, et al.. Guidelines for newborn screening of congenital hypothyroidism (2021 revision). Clin Pediatr Endocrinol 2023;32:26–51. https://doi.org/10.1297/cpe.2022-0063.Search in Google Scholar PubMed PubMed Central

22. Abbasi, F, Janani, L, Talebi, M, Azizi, H, Hagiri, L, Rimaz, S. Risk factors for transient and permanent congenital hypothyroidism: a population-based case-control study. Thyroid Res 2021;14:11. https://doi.org/10.1186/s13044-021-00103-3.Search in Google Scholar PubMed PubMed Central

23. Wang, Z, Zhu, W, Mo, Z, Wang, Y, Mao, G, Wang, X, et al.. An increase in consuming adequately iodized salt may not be enough to rectify iodine deficiency in pregnancy in an iodine-sufficient area of China. Int J Environ Res Public Health 2017;14:206. https://doi.org/10.3390/ijerph14020206.Search in Google Scholar PubMed PubMed Central

24. Liu, X, Sun, J, Fang, W, Xu, Y, Zhu, Z, Liu, Y. Current iodine nutrition status and morbidity of thyroid nodules in mainland China in the past 20 years. Biol Trace Elem Res 2021;199:4387–95. https://doi.org/10.1007/s12011-020-02565-2.Search in Google Scholar PubMed PubMed Central

Received: 2023-12-26
Accepted: 2024-06-08
Published Online: 2024-06-25
Published in Print: 2024-08-27

© 2024 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Original Articles
  3. Association between perinatal and obstetric factors and early age at diagnosis of type 1 diabetes mellitus: a cohort study
  4. Outcomes of growth hormone treatment in children with Prader–Willi syndrome over a 30-year period: a single tertiary center experience
  5. Early blood glucose screening in asymptomatic high-risk neonates
  6. Effectiveness of whole exome sequencing analyses in the molecular diagnosis of osteogenesis imperfecta
  7. Evaluation of aortic elasticity properties in mucopolysaccharidosis patients; effect of enzyme replacement therapy (ERT) on aortic stiffness
  8. Incidence and associated risk factors of congenital hypothyroidism among newborns in Hainan, China: a retrospective study
  9. Retrospective evaluation of patients diagnosed with central precocious puberty who reached the final height
  10. Short Communications
  11. Adult endocrinologists’ perspectives on transitioning adolescent patients with congenital adrenal hyperplasia
  12. Robust growth hormone responses to GH-releasing peptide 2 in adolescents
  13. Case Reports
  14. STX16 exon 5–7 deletion in a patient with pseudohypoparathyroidism type 1B
  15. Dihydropyrimidinase deficiency with atrioventricular septal defect: a case report
  16. Novel homozygous mutation in SCNN1A gene in an Iranian boy with PHA1B
  17. SRY-positive 45,X/46,XY karyotype in a phenotypically Turner-like Chinese adolescent female with ovarian dysgerminoma and gonadoblastoma
  18. Erratum
  19. Timing of onset of menses after GnRH agonist treatment for central precocious puberty
https://doi.org/10.1515/jpem-2023-0571
Keywords for this article
congenital hypothyroidism; newborn; incidence; risk factor; newborn screening

Articles in the same Issue

  1. Frontmatter
  2. Original Articles
  3. Association between perinatal and obstetric factors and early age at diagnosis of type 1 diabetes mellitus: a cohort study
  4. Outcomes of growth hormone treatment in children with Prader–Willi syndrome over a 30-year period: a single tertiary center experience
  5. Early blood glucose screening in asymptomatic high-risk neonates
  6. Effectiveness of whole exome sequencing analyses in the molecular diagnosis of osteogenesis imperfecta
  7. Evaluation of aortic elasticity properties in mucopolysaccharidosis patients; effect of enzyme replacement therapy (ERT) on aortic stiffness
  8. Incidence and associated risk factors of congenital hypothyroidism among newborns in Hainan, China: a retrospective study
  9. Retrospective evaluation of patients diagnosed with central precocious puberty who reached the final height
  10. Short Communications
  11. Adult endocrinologists’ perspectives on transitioning adolescent patients with congenital adrenal hyperplasia
  12. Robust growth hormone responses to GH-releasing peptide 2 in adolescents
  13. Case Reports
  14. STX16 exon 5–7 deletion in a patient with pseudohypoparathyroidism type 1B
  15. Dihydropyrimidinase deficiency with atrioventricular septal defect: a case report
  16. Novel homozygous mutation in SCNN1A gene in an Iranian boy with PHA1B
  17. SRY-positive 45,X/46,XY karyotype in a phenotypically Turner-like Chinese adolescent female with ovarian dysgerminoma and gonadoblastoma
  18. Erratum
  19. Timing of onset of menses after GnRH agonist treatment for central precocious puberty
Downloaded on 29.4.2026 from https://www.degruyterbrill.com/document/doi/10.1515/jpem-2023-0571/html?lang=en
Scroll to top button