My opinion

By Dr. Thirunavukkarasu Arun babu
Corresponding Author Dr. Thirunavukkarasu Arun babu
Department of Paediatrics, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India. , Plot number 17, 3rd Cross, Sri Moogambigai Nagar, Reddiyarpalayam - India 605010
Submitting Author Dr. Thirunavukkarasu Arun babu

Congenital Hypothyroidism, Universal Screening, India

Arun babu T. The Need For Universal Neonatal Screening For Congenital Hypothyroidism In India. WebmedCentral ENDOCRINOLOGY 2010;1(9):WMC00681
doi: 10.9754/journal.wmc.2010.00681
Submitted on: 23 Oct 2010 12:58:03 AM GMT
Published on: 19 Sep 2010 03:57:20 PM GMT

My opinion

Thyroid hormone plays a critical role in the development and maturation of the fetal brain.Deficient production of thyroid hormone or a defect in thyroid hormone receptor activity can lead on to hypothyroidism. Congenital hypothyroidism (CH) is one of the most common preventable causes of mental retardation in children.The incidence of CH in India is estimated to be 2.1 per 1000 live births which is at least eight times higher than what is reported in western literature. Universal neonatal screening has been acknowledged as the most effective method to prevent the severe developmental and physical morbidities associated with congenital hypothyroidism (CH). However, despite proven benefits, efforts to implement it in India are still in its infancy.
Congenital hypothyroidism features manifest minimally at birth making it difficult to pick up cases on the basis of clinical features alone.Clinical diagnosis is made in only 10% children in the first month of life and 30% in the first 3 months.Hence there is a high risk of delayed diagnosis exposing the child to various degrees of developmental delay.


In view of the high incidence, apparently asymptomatic nature, propensity to cause neurodevelopmental delay and residual impairment even with treatment, early detection and treatment of CH would be the most cost effective method to confront this problem. Despite the crushing evidence of high incidence of CH, India continues to await a plausible universal screening program. It is high time we start routine neonatal screening for CH to tackle this preventable cause of mental retardation.


1. Sanghvi U, Diwakar KK. Universal newborn screening for congenital hypothyroidism. Indian Pediatr 2008; 45(4): 331-2.
2. Hulse JA, Grant DB, Clayton BE, Lilly P, Jackson D, Spracklan A, et al. Population screening for congenital hypothyroidism. Br Med J 1980; 280(6215): 675-8.
3. Price DA, Ehrlich RM, Walfish PG. Congenital hypothyroidism. Clinical and laboratory characteristics in infants detected by neonatal screening. Arch Dis Child 1981; 56(11): 845-51.
4. Rastogi MV, Lafranchi SH. Congenital hypothyroidism. Orphanet J Rare Dis 2010; 5(1): 17.

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