Recent studies done in south India have pointed out that the prevailing rate of congenital hypothyroidism has increased to one in 2000 live births as compared to one in 4000 reported in international literature.
Nine out of ten babies suffering with congenital hypothyroidism will not be detected at birth on clinical examinations, as they seem to be normal. On International Thyroid Day on May 25, endocrinologists, thyroid surgeons and nuclear medicine specialists are concerned over the increasing prevalence of hypothyroidism during birth and are urging for a national screening program.
“Screening of newborns can help detect the onset of thyroid disorders as well as help prevent the stunting of physical and mental growth of children and even mental retardation,” said Dr Unnikrishnan of the Indian Thyroid Society. Thyroid gland, a butterfly-sized gland situated at the base of the neck, is responsible for secreting hormones into the bloodstream, and regulating the body’s metabolism like eating and sleeping.
In recent past, there has been an increase in the number of congenital hypothyroidism but experts believe it is because of early screening. “There is no direct evidence of increase in the number of cases except that the screening of the diseases affecting newborns has been scaled up,” said Dr Manoj Chadha, consultant endocrinologist at Hinduja hospital.
Screening of congenital hypothyroidism has picked up pace in metropolitan cities and also made its way in tier two cities but has not percolated to rural areas and corporation hospitals in cities where medical experts fear more such cases. Late detection or if gone undetected, children may suffer mental retardation. “This is because thyroid hormone is important for brain development in foetus and the new-born,” said Dr Krishnan adding, “If the newborn has persistent constipation, prolonged jaundice or cries hoarsely, chances are that the newborn may have a thyroid problem.”
“Since the tests are widely available, more cases are being detected. The ideal time to diagnose is 72 hours after birth. Usually diagnosis is done taking the cord blood of the baby. If diagnosis is missed at that stage, on sixth or seventh day of life, the baby should undergo a simple test called thyroid stimulating hormone test,” said Dr Chadha. With iodized salt, number of goitre cases -where the thyroid gland swells- has been drastically reduced but there is still a long way to go, say doctors. “In western countries, it is routine to screen for thyroid disorder soon after birth. India should also include it in their national program and ensure better future for the children,” said Dr Krishnan.