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The Influence of the Use of Iodine during Perinatal Period on the Screening Test for Congenital Hypothyroidism

Journal of the Korean Pediatric Society 1996;39(2):195-206.
Published online February 15, 1996.
The Influence of the Use of Iodine during Perinatal Period on the Screening Test for Congenital Hypothyroidism
Gyu Bum Cho, Dong Hwan Lee, Sang Jhoo Lee
Department of Pediatrics, College of Medicine, Soonchunhyang University, Seoul, Korea
주산기에 사용하는 소독제내의 요드가 신생아 갑상선 기능저하증의 선별검사에 미치는 영향
조규범, 이동환, 이상주
순천향대학교 의과대학 소아과학교실
: This study was performed to detect the diseases of congenital hypothyroidism by the neonatal mass screening test early and to demonstrate the possible role of topical iodinated antiseptics(povidone-iodine, PVP-Ⅰ) on transient hyperthyrotropinemia in newborn infants.
: We performed neonatal screening tests for inborn errors of metabolism since 1985 by Guthrie test for PKU, maple syrup urine disease, histidinemia, and homocystinuria and enzyme-linked immunosorbent test for TSH. And for our prospective study, 366 newborns with a appropriate gestational age (between 37 and 42 weeks) were submitted to TSH screening test. We divided the study subjects into 4 groups; the group used PVP-Ⅰ for mother and alcohol for cord care was categorized as Group A, the group used PVP-Ⅰ for both mother and cord care as Group B, the group used triple dye for mother and PVP-Ⅰ for cord care as Group C, and the group used triple dye for mother and alcohol for cord as Group D.
: 1) By neonatal screening test for inborn errors of metabolism during the last 10 years, we detected one case of phenylketonuria (PKU), one case of histidinemia and 28 cases of congenital hypothyroidism. The incidence of congenital hypothyroidism was 1 in 3,918 live births. 2) The mean TSH levels were 6.25±5.09 μU/ml(male 5.85±4.77 and female 6.6±5.41 μU/ml) in Group A, 8.30±7.68 μU/ml(male 6.30±7.15 and female 9.98±7.77U/ml) in Group B, 7.42±5.35 μU/ml(male 7.40±6.11 and female 7.44±4.63 μU/ml) in Group C, and 6.33±1.95 μU/ml(male 6.19±1.90 and female 6.42±2.03 μU/ml) in Group D, There were statistically significance between Group A and Group B, and Group D, but there was no statistically significance between gender. 3) The number of the newborns showed high levels of TSH over 15 μU/ml were 4.2%, 26.7% and 7.7% in Group A, B, and C, respectively. But nobody showed high TSH level over 15 μU/ml in Group D without use of PVP-Ⅰ
: In conclusion, we might be concerned for neonatal mass screening test on a national scale to prevent mental retardation and it is necessary to switch the povidone-iodine to other preparations as a perinatal antiseptics because of the possibility of the effect on neonatal screening test for congenital hypothyroidism.
Key Words: Neonatal Screening, Congenital hypothyroidism, Povidone-iodine, Umbilical cord

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