Congenital hypothyroidism screening in term neonates using umbilical cord blood TSH values

Congenital hypothyroidism remains one of the most common preventable causes of mental retardation among children. Screening for congenital hypothyroidism remains one of the most cost-effective tools to prevent mental retardation in the population. Umbilical cord blood thyroid-stimulating hormone (TSH) levels remain an attractive and a practical step for screening for congenital hypothyroidism. The aims of this study were as follows: (1) to find normative values of cord blood TSH for the study group and (2) to use cord blood TSH levels as a marker for screening of congenital hypothyroidism. Cord blood of 1824 neonates who were of term gestation, weighed >2.5 kg at birth, whose mothers were off thyroid medication were a part of the study group. Umbilical cord blood was collected at the time of delivery and TSH was estimated. All babies who had a cord blood TSH value of >20 mIU/L were called bay on day 7 of life for a full thyroid profile. Cord blood samples of 1824 neonates were tested for TSH. Male–female ratio was 979:845 = 1.15:1. The birth weights ranged between 2.5 and 4.5 kg with an average birth weight of 2.811 kg. Mean (standard deviation) TSH value was 7.725 (8.99). TSH values ranged between 1.2 and 100 mIU/ml. TSH values corresponding to the 3rd, 10th, 25th, 50th, 90th, 95th, and 97th percentile were 2.32, 4.05, 5.67, 7.5, 12, 20.63, and 30.88, respectively. Out of the 88 babies recalled for repeat testing, 80 babies only turned up; eventually one turned out to be hypothyroid on repeat testing. The incidence of congenital hypothyroidism in our study was 1 in 1824. To conclude, we can safely use a cutoff of cord blood TSH value of >20 mIU/L for the purpose of screening for congenital hypothyroidism. For logistic angles, a higher cutoff of >30 mIU/L can be used. Large population-based studies are required to establish normative values for cord blood TSH in our country

Congenital Malaria due to Plasmodium Vivax Infection in a Neonate

Although malaria is endemic in India, congenital malaria is not very common. Congenital malaria is a very rare condition in both endemic and nonendemic areas. We report a case of congenital malaria in a six-day-old neonate with fever and splenomegaly. The diagnosis was picked up accidentally on a peripheral smear examination. Congenital malaria should be kept as differential diagnosis of neonatal sepsis. Timely detection of this condition could lead to early diagnosis and treatment, thereby preventing neonatal mortality

MATERNAL FACTORS ASSOCIATED WITH LOW BIRTH WEIGHT NEWBORNS IN A TERTIARY CARE CENTRE OF SOUTHERN RAJASTHAN.: Maternal factors associated with Low birth weight newborns

Introduction: Low birth weight is defined as weight at birth of less than 2500 g as per WHO. LBW is associated with foetal and perinatal morbidity and mortality. The aim of the study is to find out the maternal factors leading to low birth weight in newborns. Methodology: A cross-sectional study was done for a period of one year. Mothers delivering term LBW babies from singleton pregnancy were taken as cases and mothers with term, normal weight newborns from singleton pregnancy were termed as control group. Babies with congenital malformations, still births and multiple gestations were excluded from the study. Written consent was obtained from the study group. Institutional ethical clearance was obtained. Results:  1256 babies were born during the study period and out of these 258 babies were weighing <2.5 kg thus the incidence of LBW <2.5 kg was 20.54%. Young maternal age (<30 yrs) and multi parity (≥3) had significantly increased LBW incidence of 28.7% and 32% respectively. Pregnancy complications like anaemia and Pre eclampsia had significantly increased incidence of LBW newborn of 33.455 and 29.1% respectively. Conclusion: Pregnancy related anaemia and hypertension are important risk factor for LBW. Young maternal age pregnancy and Poor ante natal visits also contributes towards LBW.   Keywords: Anaemia; Pre eclampsia; LB