Make Newborn Screening for Congenital Hypothyroidism Mandatory in Karnataka

By Manu Sharma

Unlike the developed nations, in India every 1 in 1172 babies is effected with congenital hypothyroidism. Endocrinologists insist on compulsory newborn screening suggesting that the Government of Karnataka to make Amendment in the Healthcare Act so its mandatory for screening both in the government and private hospitals.

Infact, 2008 Goa become the first state to have made this act mandatory and the panel of endocrinologists in Bengaluru want Karnataka to become the second state to amend this act.

Our country is slowly emerging as a world leader in medical advancements. India is now a major provider of health services and we have some of the most highly skilled and qualified medical providers in the world. However, quality healthcare and lack of national care has produced severe health issues throughout the nation. One such major health concern is that of ‘Congenital Hypothyroidism’ (CH) which affects numerous newborns in India.

To get discussions rolling, Dr Mala Dharmalingam (Professor and Head of Department, MS Ramaiah Medical College), Dr Anjana Hulse, (Consultant Pediatric Endocrinologist, Apollo Hospitals), Dr Praveen Ramachandra, (Director – Endocrinologist, Diaplus Clinic, Yelahanka Newtown) and Dr Nishita Rao, (Specialist in Obstetrics & Gynaecology, Lakshmi Maternity & Surgical Centre) came together to evaluate associated risks and minimize possible threats for Congenital Hypothyroidism by early intervention.

Highlighting the current situation in Bangalore, Dr Mala Dharmalingam, (Professor and Head of Department, MS Ramaiah Medical College) said, “Thyroid hormone plays an important role in development of the brain and other functions of the body like metabolism, growth and development and deficiency of this causes Congenital Hypothyroidism. All newborns should definitely be screened for CH at birth. If not screened, diagnosed and treated in appropriate time; it can lead to mental retardation. Once a baby is diagnosed with CH, the baby is started on thyroid hormone replacement. Today, though the levels of awareness remain low in general, we have seen a considerable increase in number of babies being screened since most gynecologists are now recommending screening at birth.”

Most newborns with Congenital Hypothyroidism appear normal at birth, even if there is complete lack of development of the thyroid gland. This is because a small amount of thyroid hormone (T4) from the mother is transferred to the baby during pregnancy. Around 10 per cent of infants with Congenital Hypothyroidism have other associated abnormalities; most commonly witnessed are cardiac abnormalities followed by abnormalities of the nervous system and eyes.

Stressing on the importance of timely identification and treatment, Dr Anjana Hulse(Consultant Pediatric Endocrinologist, Apollo Hospitals), stated, “In most cases of Congenital Hypothyroidism, children do not have evident symptoms and they appear to be physically normal and therefore difficult to detect. There is a need to have a legislation which mandates universal screening programmes. The treatment is simple and cost effective. Levothyroxine given orally everyday is the treatment of choice. No baby should be left to suffer the circumstances because he/she was undiagnosed.”

Highlighting the precautionary measures expecting mothers should take, Dr Nishita Rao, (Specialist in Obstetrics and Gynaecology, Lakshmi Maternity and Surgical Centre), said, “The birth of their baby is probably one of the most memorable moments in a parent’s life. In order to keep the newborn safe from any complications, screening is extremely important.What is most important is for expecting mothers to be more aware and keep thyroid levels under a constant check. Early detection and supplementation of thyroid hormone is easy, inexpensive and effective. Small and simple preventive measures can reduce large number of complications.”

On a concluding note, Dr Praveen Ramachandra, (Director – Endocrinologist, Diaplus Clinic, Yelahanka Newtown),“Of all endocrine disorders that a child can be born with, CH, is not only one of the most common, but also the most detrimental if not detected in time. If every new born is screened; no child will suffer from disastrous effects of Congenital Hypothyroidism.”