• ADNAN MOHAMMED HASAN Department of Pediatrics, School of Medicine, University of Sulaimani, Sulaimani, Kurdistan Region, Iraq.
  • HEERSH HMH RAOF SAEED Department of Pediatrics, School of Medicine, University of Sulaimani, Sulaimani, Kurdistan Region, Iraq.
  • BAKIR RAHIM RASHID, Department of Pediatrics, School of Medicine, University of Sulaimani, Sulaimani, Kurdistan Region, Iraq
  • PISHDAR ABDULLAH Sulaimani Pediatric Teaching Hospital, Sulaimani, Kurdistan Region, Iraq.
Keywords: Congenital Hypothyroidism, Sulaimani city, Newborn screening programs


Background: Congenital hypothyroidism is one of the most common preventable causes of intellectual disability. Most neonates born with congenital hypothyroidism are normal on clinical examination. Hypothyroidism in the newborn period is almost always overlooked, and as a result delay in management will cause profound neurological insult and mental retardation. Neonatal screening in Sulaimani city (center of Sulaimani governorate in north of Iraq) had started in 2013 for screening of Phenylketonuria, congenital hypothyroidism and glucose 6 phosphatase deficiency.

Subject and Method: All neonates born in Sulaimani city including all hospital deliveries (both private and public governmental hospitals) in addition to the home deliveries that were referred to (Registration Bureau of Births and Deaths) during the period from January 1st to December 31st 2014 were included. Thyroid stimulating hormone was measured from heel prick blood samples obtained from neonates aged between 3 and 10 days. Neonates showing a TSH level of ≥ 5mIU/L were recalled to Sulaimani pediatric teaching hospital for confirmation of diagnosis. Aim of our study was to determine annual incidence of congenital hypothyroidism in the city.

Results: Among 13050 neonates screened for congenital hypothyroidism, 75 (0.5%) were recalled (TSH, ≥ 5mIU/L). Congenital hypothyroidism was detected in 11 (14.6%) recalled neonates (incidence of congenital hypothyroidism in our study 1 in 1186 live births).

Conclusions: According to this result, we concluded that Sulaimani city have high incidence of congenital hypothyroidism and in future, all newborn should be screened in this region including district areas.


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1. Bernal J. Action of thyroid hormone in brain. J Endocrinol Invest 2002;25(3):268-88
2. Zoeller Rt, Rouext J. Timing of thyroid hormone action in the developing brain: clinical observations and experimental findings. J Neuroendocrionol 2004;16(10):804-18.
3. Bhavani N. Transient congenital hypothyroidism. Indian J Endocrinol Metab. 2011;15:S117-S120.
4. Srinivasan R, Harigopal S, Turner S, Cheetham T. Permanent and transient congenital hypothyroidism in preterm infants. Acta Paediatr. 2012;101:e179-e182.
5. Zung A, Yehieli A, Almashanu S. Neonatal hyperthyrotropinemia is associated with low birth weight: a twin study. Eur J Endocrinol. 2013;168:263-269.
6. Yaman AK, Demirel F, Ermis B, Piskin IE. Maternal and neonatal urinary iodine status and its effect on neonatal TSH levels in a mildly iodine-deficient area. J Clin Res
Pediatr Endocrinol. 2013;5:90-94.
7. Hanna CE, Krainz PL, Skeels MR, Miyahira RS, Sesser DE, LaFranchi SH. Detection of congenital hypopituitary hypothyroidism: ten-year experience in the Northwest Regional Screening Program. J Pediatr 1986; 109:959.
8. Alm J, Hagenfeldt L, Larsson A, Lundberg K. Incidence of Congenital Hypothyroidism: retrospective study of neonatal laboratory screening versus clinical symptoms as indicators leading to diagnosis. Br Med J (Clin Res Ed) 1984; 289:1171.
9. Law WY, Bradley DM, Lazarus JH, John R, Gregory JW. CH in Wales (1982-1993): demographic features, clinical presentation and effects on early neurodevelopment. Clin Endocrinol (Oxf) 1998; 48:201.
10. Van Vliet G, Larroque B, Bubuteishvili L, Supernant K, Leger J. Sex-specific impact of Congenital Hypothyroidism due to thyroid dysgenesis on skeletal maturation in term newborns. J Clin Endocrinol Metab 2003; 88:2009.
11. LaFranchi SH, Murphey WH, Foley TP Jr, Larsen PR, Buist NRM. Neonatal hypothyroidism detected by the Northwest Regional Screening Program. Pediatrics 1979; 63:180.
12. Klein AH, Meltzer S, Kenny FM. Improved prognosis in Congenital Hypothyroidism treated before age three months. J Pediatr 1972; 81:912.
13. Dussault JH, Coulombe P, Laberge C, Letarte J, Guyda H, Khoury K. Preliminary report on a mass screening program for neonatal hypothyroidism. J Pediatr 1975; 86:670.
14. Dussault JH. The anecdotal history of screening for congenital hypothyroidism. J Clin Endocrinol Metab. 1999;84(12):4332–4. [PubMed]
16. Fisher DA, Dussault JH, Foley TP, Jr, Klein AH, LaFranchi S, Larsen PR, et al. Screening for congenital hypothyroidism: results of screening one million North American infants. J Pediatr. 1979;94(5):700–5. [PubMed]
17. Fisher DA, Schoen EJ, La Franchi S, Mandel SH, Nelson JC, Carlton EI, et al. The hypothalamic-pituitary-thyroid negative feedback control axis in children with treated congenital hypothyroidism. J Clin Endocrinol Metab. 2000;85(8):2722–7. [PubMed]
18. Fisher DA. Euthyroid lowT4(T4) and T3 (T3) states in prematures and sick neonates. Pediatr Clin North Am 1990; 37:1297.
19. Selva KA, Harper A, Downs A, Blasco PA, Lafranchi SH. Neurodevelopmental outcomes in Congenital Hypothyroidism: comparison of initial T4 dose and time to reach target T4 and TSH. J Pediatr 2005; 147:775.
20. LaFranchi SH, Austin J. How should we be treating children with Congenital Hypothyroidism? J Pediatr Endocrinol Metab 2007; 20:559.
21. Germak JA, Foley TP Jr. Longitudinal assessment of L-thyroxine therapy for Congenital Hypothyroidism. J Pediatr 1990; 117:211.
22. American Academy of Pediatrics, Rose SR, Section on Endocrinology and Committee on Genetics, American Thyroid Association. Update of newborn screening and therapy for Congenital Hypothyroidism. Pediatrics 2006; 117:2290.
23. Loeber JG. Neonatal screening in Europe; the situation in 2004. J Inherit Metab Dis 2007;30(4): 430-8.
24. Mengreli C, Yiannakou L, Pantelakis S. The screening programme for congenital hypothyroidism in Greece: evidence of iodine deficiency in some areas of the country. Acta Paediatr Suppl. 1994;394:47-51.
25. Majeed-Saidan M.A., Joyce J., Khan M., Hamam H.D., Congenital hypothyroidism: the Riyadh Military Hospital experience, Clin. Endocrinol. 38 (1993) 191-195.
26. Ordookhani A, Mirmiran M, Hedayati M, Mirjalili F. An interim report of the pilot study of screening for congenital hypothyroidism in Tehran and Damavand using cord blood spot samples. Euro J Pediatr 2003;162(3):202-3.
27. Karamizadeh Z, Amirhakimi GH. Incidence of congenital hypothyroidism in Fars province, Iran. Iran J Med Sci 1992;17(1-2):78-80.
28. Hashemipour M, Amini M, Iranpour R, Dana MK, Amini M, Iran Pour R, et al. Prevalence of congenital hypothyroidism in Isfahan, Iran: results of a survey on 20,000 neonates. Horm Res 2004;62(2):79-83.
29. Ammash IS, Aldoree F, Al- Jumaily A, Sulaiman TI, Mahmood WT. J Fac Med Baghdad 2008, Vol. 50, No.4,page 416.
30. Fagela-Domingo C, Padilla CD, Cutiongco EM. Screening for congenital hypothyroidism among Philippine newborn infants. Philippine newborn screening study group. Southeast Asian J Trop Med Public Health 1999;30(Suppl 2):20-22.
31. Simsek E, Karabay M, Kocabay K. Neonatal screening for congenital hypothyroidism in West Black Sea area, Turkey. Int J Clin Pract 2005;59:336-341.
32. Mikelsaar RV, Zordania R, Viikmaa M, Kudrjavtseva G. Neonatal screening for congenital hypothyroidism in Estonia. J Med Screen 1998;5:20-21.
35. Moslinger D, Frisch H, Strobl W, Stockler-Ipsiroglu S. Neonatal screening for congenital hypothyroidism. Acta Med Austriaca. 1997;24(4):162-4.
36. Peter F, Blatniczky L, Kovacs L, Tar A. Experience with neonatal screening for congenital hypothyroidism in Hungary. Endocrinol Exp. 1989;23(2):143-51.
37. Yordam N, Calikoglu AS, Hatun S, Kandemir N, Oguz H, Tezic T, et al. Screening for congenital hypothyroidism in Turkey. Eur J Pediatr. 1995;154(8):614-6.
38. Berardi R, Baracchi MR, Borgogni P, Margollicci MA, Mattei R, Fois A. [Results of a screening project for congenital hypothyroidism in 4 years of experience]. Pediatr Med Chir. 1982;4(6):657-60.
39. Dilli D, Czbaş S, Acıcan D, Yamak N, Ertek M, Dilmen U. Establishment and development of a national newborn screening programme for congenital hypothyroidism in Turkey J Clin Res Pediatr Endocrinol 2013;5:73-79.
40. Olney RS, Grosse SD, Vogt RF Jr. Prevalence of congenital hypothyroidism-current trends and future directions: workshop summary. Pediatrics 2010;125(Suppl 2):31-36.
41. Al-Maghamsi MS, Al-Hawsawi ZM, Ghulam GN, Okasha AM. Screening for congenital hypothyroidism in north-west region of Saudi Arabia. Saudi Med J 2002;23:1518-1521.
42. Miyai K, Inaoka K, Miyagi T; Committee for Newborn and Infant Screening in Osaka (CONISO). Further studies on episodic occurrence of congenital dysgenetic hypothyroidism in Osaka, Japan. Endocr J 2005;52:599-603.
43. Castanet M, Polak M, Bonaiti-Pellie C, Lyonnet S, Czernichow P, Leger J; AFDPHE (Association Francaise pour le Depistage et la Prevention des Handicaps de l’Enfant). Nineteen years of national screening for congenital hypothyroidism: familial cases with thyroid dysgenesis suggest the involvement of genetic factors. J Clin Endocrinol Metab 2001;86:2009-2014.
44. Rastogi M, Lafranchi S. Congenital hypothyroidism OJRD 2010;5:17-22.
45. Panamonta O, Tuksapun S, Kiatchoosakun P, Jirapradittha J, Kirdpon W, Loapaiboon M. Newborn screening for congenital hypothyroidism in Khon Kean university hospital. J Med Assoc Thai 2003;86(10):932-9.
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