Newborn Screening TSH Values Less Than 15 mIU/L Are Not Associated With Long-term Hypothyroidism or Cognitive Impairment
Open accessAbstract
Background: It is unclear whether newborns with mild thyrotropin elevation (mTSHe) are at risk of neurocognitive impairment. We assessed whether mTSHe at birth persists during childhood and compared neurocognitive functioning to siblings. Methods: This study encompassed children born in the Auckland region (New Zealand) with a newborn screen TSH level of 8 to 14 mIU/L blood, age 6.9 to 12.6 years at assessment, and their siblings. Thyroid function tests (serum TSH and free thyroxine) and neurocognitive assessments were performed, including IQ via the Wechsler Intelligence Scale for Children, fourth edition. Results: Ninety-six mTSHe individuals were studied, including 67 children recruited with 75 sibling controls. Mean mTSHe newborn TSH level was 10.1 mIU/L blood and 2.4 mIU/L at assessment (range, 0.8-7.0 mIU/L, serum). Although higher newborn TSH levels in the mTSHe group correlated with lower full-scale IQ scores (r = 0.25; P = .040), they were not associated with the magnitude of the IQ difference within sibling pairs (P = .56). Cognitive scores were similar for mTSHe and controls (full-scale IQ 107 vs 109; P = .36), with a minor isolated difference in motor coordination scores. Conclusions: Our data do not suggest long-term negative effects of neonatal mild TSH elevation. TSH elevation below the screen threshold appears largely transient, and midchildhood neurocognitive performance of these children was similar to their siblings. We propose that associations between neonatal mild TSH elevation and IQ are due to familial confounders. We caution against the practice of reducing screening CH cutoffs to levels at which the diagnosis may not offer long-term benefit for those detected.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the elderly, the upper bound of the TSH reference interval progressively increases with age.
“At the other age extreme, in the elderly, the upper bound of the TSH reference interval progressively increases with age and should be reflected in laboratory reports and taken into consideration for clinical interpretation of TSH test results.”
From Thyroid Stimulating Hormone and Thyroid Hormones (Triiodothyronine and Thyroxine): An American Thyroid Association-Commissioned Review of Current Clinical and Laboratory Status (2023) · cites this paper as [43]
The Introduction discusses newborn screening cutoffs and the baby's age at sampling; Study parameters gives a TSH reference range for children aged 1–18 years. Searches for elderly TSH reference intervals and age-related upper limits found no passage addressing whether the upper bound increases with age in older adults. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Bath, S. C., Steer, C. D., Golding, J., Emmett, P. M., & Rayman, M. P. (2013) · The Lancet · doi:10.1016/s0140-6736(13)60436-5 · Cited by 733 · see citing works
NZDep2013 Index of Deprivation
Atkinson, J., Salmond, C. E., & Crampton, P. (2014) · Cited by 607 · see citing works
Léger, J., Olivieri, A., Donaldson, M., Torresani, T., Krude, H., van Vliet, G., Polak, M., Butler, G., & on behalf of ESPE-PES-SLEP-JSPE-APEG-APPES-ISPAE, A. T. C. H. C. C. G. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-1891 · Cited by 569 · see citing works
Genetic foundations of human intelligence
Deary, I., Johnson, W., & Houlihan, L. M. (2009) · Human Genetics · doi:10.1007/s00439-009-0655-4 · Cited by 385 · see citing works
Screening for congenital hypothyroidism: A worldwide view of strategies
Ford, G., & LaFranchi, S. H. (2014) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2013.05.008 · Cited by 274 · see citing works
Corbetta, C., Weber, G., Cortinovis, F., Calebiro, D., Passoni, A., Vigone, M. C., Beck‐Peccoz, P., Chiumello, G., & Persani, L. (2009) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2009.03568.x · Cited by 247 · see citing works
Grosse, S. D., & Van Vliet, G. (2011) · Archives of Disease in Childhood · doi:10.1136/adc.2010.190280 · Cited by 222 · see citing works
Zimmermann, M. B., Herter‐Aeberli, I., Torresani, T., & Bürgi, H. (2005) · American Journal of Clinical Nutrition · doi:10.1093/ajcn.82.2.388 · Cited by 172 · see citing works
Perry, R., Heinrichs, C., Bourdoux, P., Khoury, K., Szöts, F., Dussault, J. H., Vassart, G., & Van Vliet, G. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2001-011995 · Cited by 167 · see citing works
Mengreli, C., Kanaka‐Gantenbein, C., Girginoudis, P., Magiakou, M. A., Christakopoulou, I., Giannoulia‐Karantana, A., Chrousos, G. P., & Dacou‐Voutetakis, C. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-0057 · Cited by 146 · see citing works
Zimmermann, M. B., Herter‐Aeberli, I., Torresani, T., et al. (2005) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/82.2.388 · Cited by 139 · see citing works
Olivieri, A., Fazzini, C., Medda, E., & The Italian Study Group for Congenital Hypothyroidism (2015) · Hormone Research in Paediatrics · doi:10.1159/000369394 · Cited by 132 · see citing works
Calaciura, F., Motta, R. M., Miscio, G., Fichera, G., Leonardi, D., Carta, A., Trischitta, V., Tassi, V., Sava, L., & Vigneri, R. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.7.8662 · Cited by 130 · see citing works
Lain, S. J., Bentley, J. P., Wiley, V., Roberts, C. L., Jack, M., Wilcken, B., & Nassar, N. (2016) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(16)30122-x · Cited by 106 · see citing works
Leonardi, D., Polizzotti, N., Carta, A., Gelsomino, R., Sava, L., Vigneri, R., & Calaciura, F. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-2612 · Cited by 101 · see citing works
Etiology of Increasing Incidence of Congenital Hypothyroidism in New Zealand from 1993–2010
Albert, B. B., Cutfield, W. S., WEBSTER, D. R., Carll, J., Derraik, J. G. B., Jefferies, C., Gunn, A. J., & Hofman, P. L. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-1562 · Cited by 100 · see citing works
Self-citationAre lower TSH cutoffs in neonatal screening for congenital hypothyroidism warranted?
Lain, S. J., Trumpff, C., Grosse, S. D., Olivieri, A., & Vliet, G. V. (2017) · European Journal of Endocrinology · doi:10.1530/eje-17-0107 · Cited by 98 · see citing works
Maternal and Birth Characteristics Are Determinants of Offspring Thyroid Function
Korevaar, T. I. M., Chaker, L., Jaddoe, V. W. V., Visser, T. J., Medici, M., & Peeters, R. P. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-3559 · Cited by 91 · see citing works
Korada, S. M., Pearce, M. S., Platt, M. W., et al. (2009) · Archives of Disease in Childhood · doi:10.1136/adc.2008.147884 · Cited by 86 · see citing works
Childhood IQ measurements in infants with transient congenital hypothyroidism*
Calaciura, F., Mendorla, G., Distefano, M., Castorina, S., Fario, T., Motta, R. M., Sava, L., Delange, F. M., & Vigneri, R. (1995) · Clinical Endocrinology · doi:10.1111/j.1365-2265.1995.tb02620.x · Cited by 85 · see citing works
Albert, B. B., Heather, N., Derraik, J. G. B., Cutfield, W. S., Wouldes, T., Tregurtha, S., Mathai, S., Webster, D., Jefferies, C., Gunn, A. J., et al. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-1903 · Cited by 75 · see citing works
Self-citationNewborn TSH concentration and its association with cognitive development in healthy boys
Freire, C., Ramos, R., Amaya, E., Fernández, M. F., Santiago, P., López-Espinosa, M.-J., Arrebola, J. P., & Olea, N. (2010) · European Journal of Endocrinology · doi:10.1530/eje-10-0495 · Cited by 75 · see citing works
Williams, F. L. R., Watson, J., Ogston, S. A., Visser, T. J., Hume, R., & Willatts, P. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-3572 · Cited by 65 · see citing works
Köhler, B., Schnabel, D., Biebermann, H., & Grüters, A. (1996) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.81.4.8636368 · Cited by 64 · see citing works
Langham, S., Hindmarsh, P. C., Krywawych, S., & Peters, C. J. (2013) · European Thyroid Journal · doi:10.1159/000350039 · Cited by 57 · see citing works
Korzeniewski, S. J., Grigorescu, V., Kleyn, M., Young, W. I., Birbeck, G., Todem, D., Romero, R., & Paneth, N. (2013) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2012.06.050 · Cited by 55 · see citing works
Trumpff, C., De Schepper, J., Vanderfaeillie, J., Vercruysse, N., Van Oyen, H., Moreno-Reyes, R., Tafforeau, J., Vanderpas, J., & Vandevijvere, S. (2015) · Nutrients · doi:10.3390/nu7115450 · Cited by 52 · see citing works
Long-Term Outcome of Loss-of-Function Mutations in Thyrotropin Receptor Gene
Tenenbaum‐Rakover, Y., Almashanu, S., Hess, O., Admoni, O., Mahameed, A. H.-D., Schwartz, N., Shalev, S. A., Bercovich, D., & Refetoff, S. (2015) · Thyroid · doi:10.1089/thy.2014.0311 · Cited by 50 · see citing works
Neonatal thyroid-stimulating hormone concentration and psychomotor development at preschool age
Trumpff, C., De Schepper, J., Vanderfaeillie, J., Vercruysse, N., Van Oyen, H., Moreno-Reyes, R., Tafforeau, J., & Vandevijvere, S. (2016) · Archives of Disease in Childhood · doi:10.1136/archdischild-2015-310006 · Cited by 42 · see citing works
Ryckman, K. K., Spracklen, C. N., Dagle, J. M., et al. (2014) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem-2013-0366 · Cited by 39 · see citing works
Heather, N. L., Hofman, P. L., de Hora, M. R., Carll, J., Derraik, J. G. B., & WEBSTER, D. R. (2016) · Clinical Endocrinology · doi:10.1111/cen.13250 · Cited by 19 · see citing works
Self-citationTanaka, K., Shimizu, T., Hosaka, A., Tokita, A., 志賀, 清., & Yamashiro, Y. (2007) · Pediatrics International · doi:10.1111/j.1442-200x.2007.02390.x · Cited by 17 · see citing works
The impact of demographic factors on newborn TSH levels and congenital hypothyroidism screening
Heather, N. L., Derraik, J. G. B., WEBSTER, D. R., & Hofman, P. L. (2019) · Clinical Endocrinology · doi:10.1111/cen.14044 · Cited by 13 · see citing works
Self-citationMissed congenital hypothyroidism in an identical twin
Azam, A., Cutfield, W. S., Mouat, F., Hofman, P. L., Jefferies, C., WEBSTER, D. R., & Gunn, A. J. (2012) · Journal of Paediatrics and Child Health · doi:10.1111/j.1440-1754.2012.02554.x · Cited by 8 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 2
- Clinical and Laboratory Standards Institute 2013 Blood collection on filter paper for newborn screening programmes; approved standard -sixth edition. In: Clinical and Laboratory Standards Institute ed. CLSI document NBS01-A6. Wayne, PA
- World Health Organization 1994 Indicators for Assessing Iodine Deficiency Disorders and their Control troug Salt Iodisation. Geneva, Switzerland: World Health Organization. · DOI
Cited by
Sorted by citations
Van Uytfanghe, K., Ehrenkranz, J., Halsall, D., Hoff, K., Loh, T. P., Spencer, C. A., Köhrle, J., & ATA Thyroid Function Tests Writing Group (2023) · Thyroid® · doi:10.1089/thy.2023.0169 · Cited by 100 · see citing works
- Authors
- West, R., Hong, J., Derraik, J. G. B., Webster, D., Heather, N. L., & Hofman, P. L.
- Affiliations
- University of Auckland (NZ)
- Uppsala University (SE)
- Corresponding author
- Heather, Natasha L
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2020-06-29
- Volume
- 105
- Issue
- 9
- Pages
- e3329-e3338
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W3037429489
- Cited by
- 20
- References
- 34
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 4 · 2022: 6 · 2021: 5 · 2020: 1
- FWCI
- 3.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- ResearchSpace (University of Auckland) (submittedVersion)
- Funders
- Ministry of Health, New Zealand
- Auckland District Health Board
- Australasian Paediatric Endocrine Group
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Keywords
- newborn screening, hypothyroidism, neurocognitive development, IQ, familial confounding, motor coordination
- MeSH terms
- Adolescent, Child, Congenital Hypothyroidism, Female, Follow-Up Studies, Humans, Infant, Newborn, Male, New Zealand, Prognosis, Reference Values, Risk Factors, Thyroid Function Tests, Thyroid Hormones, Thyrotropin, Neonatal Screening, Case-Control Studies, Age of Onset, Siblings, Cognitive Dysfunction
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
