BACKGROUND Congenital hypothyroidism is a common, yet easily treatable cause of poor growth and intellectual disability. Newborn screening programs play an important role in the early detection and treatment of congenital hypothyroidism. However, an estimated 71% of children are born in countries such as Ghana, which does not have a screening program. Iodine deficiency, a common cause of congenital hypothyroidism, is present in the Ghanaian population. Mild to moderate maternal iodine deficiency may negatively impact cognitive function in children. A structured approach to examine the association between maternal iodine levels and infant thyroid function may have important ramifications on our understanding of congenital hypothyroidism in Ghana. We investigated the hypothesis that maternal iodine deficiency impacts infant thyroid function, using Thyroid Stimulating Hormone (TSH) as a marker of thyroid function. We also explored potential opportunities and barriers to newborn screening for congenital hypothyroidism in Ghana. METHODS This was a cross-sectional, multicenter pilot study of 250 women and their neonates recruited from post-natal clinics in Accra and Tamale, Ghana. We compared maternal urine iodine concentration and infant TSH, as well as maternal sociodemographic and nutrition information. Regression models were used to model the relationship between variables. RESULTS Median infant TSH was 4.7 μIU/ml (95% CI: 3.9-5.5) in Accra. In Tamale, the median infant TSH was 3.5 μIU/ml (95%CI: 3.3 to 3.6) (Δ: 1.3 μIU/ml, 95% CI: 0.5-2.1, p = 0.002). Median maternal urine iodine concentrations were 141.0 μg/L (95% CI: 115.7 to 166.3) and 142.5 μg/L (95% CI: 125.1 to 160.0) in Accra and Tamale, respectively (Δ: - 1.5 μIU/ml, 95% CI: - 32.2 - 29.2, p = 0.925). There was a weakly positive correlation between maternal urine iodine and infant TSH (rho 0.1, p = 0.02). Almost one-third (30%) of women in both locations had biochemical evidence of iodine deficiency. Mothers with any formal education were more likely to have higher iodine levels than their counterparts who had no formal education (coefficient 0.31, p = 0.006). CONCLUSIONS Maternal iodine deficiency is prevalent in Ghana and is correlated to infant thyroid function. We recommend studies with larger sample sizes to assess the true scope of this relationship.

中文翻译：

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加纳两个医院人口的孕妇碘状态与新生儿甲状腺功能的相关性：一项多中心横断面先导研究。

背景技术先天性甲状腺功能减退是生长不良和智力残疾的常见但易于治疗的原因。新生儿筛查程序在早期发现和治疗先天性甲状腺功能减退中起着重要作用。但是，估计有71％的孩子出生在加纳等没有筛查计划的国家/地区。加纳人群中普遍存在碘缺乏症，这是先天性甲状腺功能低下症的常见原因。孕妇中度至轻度缺碘可能会对儿童的认知功能产生负面影响。研究孕产妇碘水平与婴儿甲状腺功能之间关系的结构化方法可能会对我们对加纳先天性甲状腺功能减退症的理解产生重要影响。我们调查了母体碘缺乏影响婴儿甲状腺功能的假说，使用甲状腺刺激激素（TSH）作为甲状腺功能的标志物。我们还探讨了加纳新生儿筛查先天性甲状腺功能减退症的潜在机会和障碍。方法这是一项对来自加纳阿克拉和塔玛利市的产后诊所招募的250名妇女及其新生儿进行的多中心横断面先导研究。我们比较了孕妇尿碘浓度和婴儿TSH，以及孕妇社会人口统计学和营养信息。回归模型用于建模变量之间的关系。结果在阿克拉，婴儿TSH的中位数为4.7μIU/ ml（95％CI：3.9-5.5）。在Tamale中，婴儿TSH中位数为3.5μIU/ ml（95％CI：3.3至3.6）（Δ：1.3μIU/ ml，95％CI：0.5-2.1，p = 0.002）。孕妇尿碘中位数浓度为141.0μg/ L（95％CI：115.7至166.3）和142.5μg/ L（95％CI：125.1至160）。0）分别在Accra和Tamale中（Δ：-1.5μIU/ ml，95％CI：-32.2-29.2，p = 0.925）。孕妇尿碘与婴儿TSH之间呈弱正相关（rho 0.1，p = 0.02）。在两个地点中，将近三分之一（30％）的妇女都有碘缺乏的生化证据。与没有接受过正规教育的母亲相比，接受过正规教育的母亲更有可能有更高的碘水平（系数0.31，p = 0.006）。结论加纳普遍存在孕妇碘缺乏症，其与婴儿甲状腺功能有关。我们建议使用更大样本量的研究来评估这种关系的真实范围。在两个地点中，将近三分之一（30％）的妇女都有碘缺乏的生化证据。与没有接受过正规教育的母亲相比，接受过正规教育的母亲更有可能有更高的碘水平（系数0.31，p = 0.006）。结论加纳普遍存在孕妇碘缺乏症，其与婴儿甲状腺功能有关。我们建议使用更大样本量的研究来评估这种关系的真实范围。在两个地点中，将近三分之一（30％）的妇女都有碘缺乏的生化证据。与没有接受过正规教育的母亲相比，接受过正规教育的母亲更有可能有更高的碘水平（系数0.31，p = 0.006）。结论加纳普遍存在孕妇碘缺乏症，其与婴儿甲状腺功能有关。我们建议使用更大样本量的研究来评估这种关系的真实范围。