Dianne Webster

Hysterosalpingography with Oil-Soluble Contrast Medium Does Not Increase Newborn Hypothyroidism

Publisher: Hindawi Limited

Date: 22-02-2022

DOI: 10.1155/2022/4532714

Abstract: Objective. Hysterosalpingography (HSG) with oil-soluble contrast medium (OSCM) improves pregnancy rates in women with idiopathic infertility. However, OSCM has high iodine content and slow clearance resulting in potential iodine excess. If pregnancy occurs, this could impact fetal thyroid gland development and function. We aim to determine the effect of a preconceptional OSCM HSG on the thyroid function of the neonate. Design and Patients. This was a retrospective analysis of newborn TSH data for a cohort of neonates conceived within six months of an OSCM HSG in the Auckland region, New Zealand, from the years 2000 to 2019. Thyroid-stimulating hormone (TSH) levels of these newborns were obtained from newborn screening, which is routinely performed for all children at 48–72 hours of life. The primary outcome was the incidence of permanent or transient congenital hypothyroidism in this cohort. Results. Of 146 babies included, all had normal TSH levels with values ranging from 1 to 7 mIU/L on the whole blood analysis of a capillary heel s le using the Perkin–Elmer AutoDelfia assay. Conception during the first 3 cycles following an OSCM HSG was 76% however, TSH levels in this group were not higher than those conceived in later cycles. Conclusion. Preconceptional OSCM HSG did not increase the risk of congenital hypothyroidism in the New Zealand scenario.

Birth Weight– or Gestational Age–adjusted Second-tier LCMSMS Cutoffs Improve Newborn Screening for CAH in New Zealand

Publisher: The Endocrine Society

Date: 31-05-2021

DOI: 10.1210/CLINEM/DGAB383

Abstract: The positive predictive value of newborn screening for congenital adrenal hyperplasia (CAH) in New Zealand is approximately 10%. The use of a second tier liquid chromatography-tandem mass spectrometry bloodspot steroid profile test with birth weight– or gestational age–adjusted screening cutoffs may result in further screening improvements. Three years of newborn screening data with additional second-tier steroid metabolites was evaluated (n = 167 672 births). Data from babies with a negative screening test and confirmed CAH cases were compared. First- and second-tier steroid measurements were correlated with both birth weight and gestational age. Analysis of variance was used to determine birth weight and gestational age groups. Screening cutoffs were determined and applied retrospectively to model screening performance. First-tier immunoassay data correlated better with gestational age than with birth weight, but there was no difference with second-tier steroid measurements. Four distinct birth weight and gestational age groups were established for 17-hydroxyprogesterone and a steroid ratio measurement. Application of 97.5th percentile second-tier birth weight– or gestational age–adjusted cutoffs would result in 10 positive tests over the period of the study with 8 true-positive screens and 2 false-positive tests. The positive predictive value of screening would be increased from 10.8% to 80%. The use of either birth weight– or gestational age–adjusted cutoffs for second-tier screening tests can significantly reduce the false positive rate of newborn screening for CAH in New Zealand without loss in screening sensitivity.

Massey University

Location: New Zealand

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Auckland District Health Board

Location: New Zealand

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The University Of Auckland

Location: New Zealand

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University Of London

Location: United Kingdom of Great Britain and Northern Ireland

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University Of London

Location: No location found

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