Congenital hypothyroidism screening in Iran

Congenital hypothyroidism screening in Iran Thyroid hormone affects the function of all organs in the body, especially during neonatal period and infancy, which is more important due to its effect on brain development and physical growth. Congenital hypothyroidism (CH) is a common disorder, and can cause irreversible intellectual disability. However, early diagnosis and treatment of congenital hypothyroidism can prevent lifelong complications of this disease, therefore, thyroid screening tests in newborns are strongly recommended. Congenital hypothyroidism occurs in approximately ۱ in ۲,۰۰۰-۴,۰۰۰ live births worldwide, however, studies conducted in Iran have reported a higher incidence rate (approximately ۱ in ۱,۰۰۰-۱,۵۰۰ live births). The most common cause of permanent congenital hypothyroidism is thyroid dysgenesis (About ۸۰-۸۵% of cases) including agenesis, hypoplasia, ectopic location. Defects in thyroid hormone biosynthesis also causes congenital hypothyroidism. Other uncommon causes include exposure to iodides, TSH deficiency, TRH deficiency, maternal goiterogen ingestion and maternal autoimmune thyroid disease. The first screening study for congenital hypothyroidism in Iran was conducted in ۱۹۸۷, before the implementation of the salt iodine enrichment program in Tehran and Damavand, but was stopped in ۱۹۸۹ due to the large number of recall cases. The screening plan for congenital hypothyroidism in Iran was implemented as a national program in ۲۰۰۳ in the first national program on a pilot basis in the Isfahan, Bushehr, and Shiraz, and finally, since ۲۰۰۵, this program has been integrated into the Iranian health system. The goals of the national neonatal hypothyroidism screening program in Iran include the following: The main goal is to identify and control infants with neonatal hypothyroidism, treat and prevent its complications. Other specific goals: early identify neonate with the CH disease, control and treat infants with the CH disease, identify infants with transient TSH elevation, control and treat infants with transient elevation if needed, improving the quality of life of patients and their families, improving the average IQ of the population by preventing the decline in IQ of affected individuals.