Neonatal iodine status survey by thyroid-stimulating hormone screening in Surabaya

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Connie Untario
I Wayan Bikin Suryawan


Background Iodine deficiency disorders (lDD) are a significant
public health problem globally. Iodine deficiency may cause
subclinical hypothyroidism during pregnancy and early infancy.
Neonatal thyroid screening of serum thyroid􀁊stimulating hormone
(TSH) to detect hypothyroidism may also be used to determine
the prevalence of IDD in a population. Previous studies reported
mild ID D status in different parts of Indonesia.
Objective To evaluate the iodine status of neonates born in
Mitra K eluarga Surabaya Hospital (MKSH) by TSH screening
over a 6􀁊year period.
Methods T his is a cross􀁊sectional and hospital􀁊based study
conducted in MKSH from January 2005 to December 2010. Of
the 5,619 infants born in MKSH during the study period, 3,349
(59.6%) healthy infants took part in this study. Blood specimens
for TSH measurement were collected from subjects 2 to 6 days
after birth, and sent to a reference laboraratory for evaluation.
Using the neonatal TSH values, the iodine deficiency level of
the group was determined according to the WHO/UNICEF/
International Council for the Control of IDD criteria.
Results A total of 3,349 newborn babies underwent neonatal
TSH screening in MKSH. Subjects' mean TSH concentration
was 5.14 mIU!L. A TSH concentration> SmIU!L was found in
1270 (37.9%) subjects, 166 (27.6%) in 2005, 252 (44.0%) in 2006,
331 (47.1 %) in 2007, 356 (57.7%) in 2008, 114 (20.7%) in 2009
and 51 (16.8%) in 2010. On the basis of the WHO/UNICEF/
International Council for the Control of Iodine Deficiency
Disorder criteria, this frequency corresponded to a moderate level
of IDD. Twenty􀁊two neonates had TSH > 20 mIU!L from which
2 infants were confirmed positive for hypothyroidism.
Conclusion A 6􀁊year study of 3,349 newborns screened for TSH
revealed that 37.9% of subjects had TSH concentration of more
than SmIU!L. This frequency indicates a moderate level of IDD
in the study population. [Paediatr Indones. 2012;52:289,93].

Article Details

How to Cite
Untario C, Suryawan IW. Neonatal iodine status survey by thyroid-stimulating hormone screening in Surabaya. PI [Internet]. 31Oct.2012 [cited 21Jul.2019];52(5):289-3. Available from:
Received 2016-09-07
Accepted 2016-09-07
Published 2012-10-31


1. Clugston G, Benoist B. Eliminating iodine deficiency
disorders. Bull World Health Organ. 2002:80:341.
2. Kibirige M, Hutchison S, Owen C, Delves HT. Prevalence
of maternal dietary iodine insufficiency in the north east of
England; implications for the fetus. Arch Dis Child F etal
Neonatal Ed. 2004:89:F436-9.
3. Kurtoglu S, Akcakus M, Kocaoglu C, Gunes T, Karakucuk I,
Kula M, et al. Iodine deficiency in pregnant women and in
their neonates in the central Anatolian region (Kayseri) of
Turkey. Turk) Pediatr. 2004:46:11-5.
4. Aziz F, Aminorroya A, Hedayati M, Rezvanian H, Amini M,
Mirmiran P. Urinary iodine excretion in pregnant women
residing in areas v.ith adequate iodine intake. Public Health Nutr. 2003;6,95-8.
5. Ardav.i M, Nasrat H, Mustafa B. Urinary iodine excretion and
maternal thyroid function. Saudi Med J. 2002;23:413􀁘22.
6. Delange F. Iodine deficiency in Europe and its consequences:
an update. Em J Nuel Med Mol Imaging. 2002;29Supp12,
7. Delange F. Screening for congenital hypothyroidism used
as an indicator of the degree of iodine deficiency and of its
control. T hyroid. 1998;8,1185-92.
8. Department of Nutrition for Health and Development, World
Health Organization. Iodine status worldv.ide: WHO Global
Database on Iodine Deficiency. Geneva: WHO; 2004.
9. Widodo US. HasH Analisa Ekresi Iodium Dalam Urine Skala
KabupateniKota Se Provinsi Jawa T imur. Dinas Kesehatan
ProvinsiJawa T imur Sub Bagian Gizi. Surabaya 2010
10. Zimmerman. Iodine deficiency. Endocrine Reviews 2009;
11. Pardede LVH, Hardjowasito W, Gross R, Dilion DHS,
Totoprajogo OS, Yosoprawoto M, et al. Urinary iodine
excretion is the most appropriate outcome indicator for
iodine deficiency at field conditions at district level. Journal
of Nutritiom. 1998;128,1122-6.
12. Ii M, Eastman C. Neonatal T SH screening: is it a sensitive
and reliable tool for monitoring iodine status in populations?
Best Pract Res Clin Endocrinol Metab. 201O;24:63􀁘 75.
13. Pyati S, Ramamurthy R, Krauss M, Pildes R. Absorption
of iodine in the neonate topical use of povidone
iodine. J Pediatr Endoctinol Metab. 1977;91,825-8.
14. lin C, Chen W, Wu K. Povidone􀁘iodine in umbilical cord care interferes with neonatal screening for hypothyroidism.
Em J Pediatr. 1994;153,756-8.
15. WHO, UNICEF, and ICCIDD. Assessment of iodine
deficiency disorders and monitoring their elimination: A
guide for programme managers, 3rd edition. Geneva: WHO;
16. Rahman A, Savige GS, Deacon NJ, Francis I, Chesters JE.
Increased iodine deficiency in Victoria, Australia: analysis of
neonatal thyroid􀁘stimulating hormone data, 2001 to 2006.
MedJ Aust. 2010;193,503-5.
17. Benoist Bd, Andersson M, Igli I, Takkouche B, Allen H,
editors. Iodine status worldv.ide: WHO Global Database on
Iodine Deficiency. Geneva: WHO; 2004.
18. Ratrisawadi V, Horpaopan S, Chotigeat U, Sangtawesin
V, Kanjanapattanakul W, Ningsanond V, et al. Neonatal
screening program in Rajavithi Hospital, T hailand. Southeast
Asian J Trop Med Public Health. 1999;30,28-32.
19. Rustama D, Fadil M, Harahap E, Primadi A. Newborn
screening in Indonesia. Southeast Asian J Trop Med Public
Health. 2003;34,76-9.
20. Mohammad N, Hossein K, Mohammad B, Masoumeh S,
Mazlom F, Fatomeh K. Neonatal thyroid screening in a mild
iodine deficiency endemic area in Iran. Indian J Med Sci.
21. International Atomic Energy Agency (lAEA). Screening
of Newborns for Congenital Hypothyroidism: Guidance
for Developing Programmes. Detection of Congenital
Hypothyroidism. Vienna: Sales and Promotion Unit,
Publishing Section IAEA; 2005. p.17.