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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Mericq, Veronica / Toppari, Jorma

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Volume 29, Issue 7


Frequency of thyroid status monitoring in the first year of life and predictors for more frequent monitoring in infants with congenital hypothyroidism

Nikolina Zdraveska / Violeta Anastasovska
  • Laboratory for neonatal thyroid screening, University Children’s Hospital, Skopje, Republic of Macedonia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Mirjana Kocova
  • Corresponding author
  • Department for Endocrinology and Genetics, University Children’s Hospital, 1000 Skopje, Republic of Macedonia
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2016-04-18 | DOI: https://doi.org/10.1515/jpem-2015-0446


Background: The essential role of thyroid hormones for normal brain development during a critical period of life is well established. Neonatal screening programs for congenital hypothyroidism (CH) enable early detection of patients and attainment of euthyroid status as quickly as possible. Adequate and accurate monitoring of thyroid function is necessary. In the study we aimed to determine the periodicity of thyroid function testing in the first year of life (3-month intervals versus <3-month intervals monitoring).

Methods: We retrospectively analyzed charts of CH children from Macedonia detected on neonatal screening during a 3-year period (2011–2014). Needs for monthly thyroid monitoring were defined according to the recommendations: a dose change within a month of a previous control, values of T4/FT4 not in the upper half of the reference range, and a high or very low thyroid-stimulating hormone (TSH) value.

Results: Monthly thyroid testing was indicated in more than a third of CH patients during the first year of life. Children who needed more frequent monitoring intervals had a higher initial value of TSH (p=0.032) and a lower value of T4 (p=0.038) than those requiring less frequent monitoring. The sex, birth weight, age of treatment onset, initial L-thyroxine dose, and L-thyroxine dose at 1-year of age in our study were not predictive factors for more frequent thyroid monitoring.

Conclusions: Children with severe hypothyroidism at birth are potential candidates for more frequent thyroid monitoring during the first year of life, although the individual patient approach should not be avoided as variations in TSH values are very common.

Keywords: congenital hypothyroidism; infants; monitoring; newborn screening; thyroid


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About the article

Corresponding author: Prof. Mirjana Kocova, MD, PhD, Department for Endocrinology and Genetics, University Children’s Hospital, 1000 Skopje, Republic of Macedonia, Phone: +389 2 3111713, Fax: +389 2 3176167

Received: 2015-11-20

Accepted: 2016-03-07

Published Online: 2016-04-18

Published in Print: 2016-07-01

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 29, Issue 7, Pages 795–800, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2015-0446.

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