Perfil epidemiológico do hipotireoidismo congênito na população do Sistema Único de Saúde do Estado do Rio Grande do Sul

Abstract

Introduction and justification: In Brazil, the Ministry of Health's National Neonatal Screening Program for Congenital Hypothyroidism (CH) has been carried out since 2001. Regional studies, developed to analyze data on screened newborns (NBs), are important for public health management. Objectives: Evaluating the epidemiological characteristics of the newborn population (NB) from the public network of Rio Grande do Sul (RS), screened from 2008 to 2017. Methodology: Retrospective population study, with data collected in the Neonatal Screening Reference Service from Rio Grande do Sul, of NB after neonatal screening between 2008 and 2017. Cases of CH were considered to be those ones with TSH results on filter paper > 9 mUI / L and confirmatory serum TSH (TSHs) > 10 mUI / L. Maternal variables (age, type of delivery, twinning, gestational complications, thyroid disease prior to pregnancy and consanguinity) and neonatal variables (sex, birth weight, gestational age, family thyroid disease, presence of congenital malformation and/or genetic syndrome) were collected for analysis of association with the diagnosis. Results: Between 2008 and 2017, out of 1.395.925 live births in RS, 1,043,565 newborns were screened. Out of those, 830 (0.08%) had TSHf > 9 mUI / L and were submitted to TSHs dosage. Congenital hypothyroidism (transient and permanent) was confirmed in 439 NBs (60.7%). The prevalence was 40.3 cases / 100,000 NBs screened (95% CI 36.8 - 43.9 / 100,000). Males showed 46% lower probability for CH [OR 0.54 (95% CI (0.39 - 0.73), p < 0.001)], compared to females, even after adjusting for the gestacional age, presence of congenital malformations, pregnancy complications and maternal age variables. Conclusion: The prevalence of CH (transient and permanent) in newborns from the public health network in RS was 1 case per 2481 live births screened. Despite the similarity with data from other studies, the comparison was limited by different methodologies and screening protocols which were used [resumo fornecido pelo autor].