{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:45:48Z","timestamp":1790390748464,"version":"4.1.0"},"reference-count":37,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2018,2,21]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate the newborn screening programme for congenital hypothyroidism (CH) in Iran from diagnosis to management and follow-up for 3\u2009years from 2011 to 2014.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Retrospective cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting and patients<\/jats:title>\n                  <jats:p>Seventeen university districts were randomly selected from 30 provinces. Central data in each district were gathered and collectively analysed. Congenital hypothyroid subjects were followed for 3\u2009years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>\n                     <jats:bold>Main outcome measures<\/jats:bold>\n                  <\/jats:title>\n                  <jats:p>Programme coverage, screening and treatment age, recall rate, compliance to follow-ups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The total number of births in 2011 was 501 726, of which 452\u2009918 neonates (90.3%) were screened and 15\u2009671 (3.46%) were recalled; 1085 (1:462, 0.22%) were confirmed as having CH (57.1%: permanent, 42.9%: transient) and followed for 3\u2009years. Positive predictive value (PPV) for the first screening test was 6.9%. After the second screening, recall rate was reduced to 0.69% and PPV increased to 31.3%. Median age at screening was 6 (3\u20139)\u2009days and for 90.6% of patients treatment was initiated before 40\u2009days of age with a median levothyroxine dosage of 25\u2009\u00b5g\/day; 131 (13.4%) were lost to follow-up. Mean number of follow-up visits over 3\u2009years was 5.7 (95% CI 5.5 to 5.9) and 23% (n=225) had total compliance to all follow-ups. Median time for thyroid stimulating hormone normalisation was 45\u2009days, 95%\u2009CI (41.1 to 48.8).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In Iran, despite well-established protocols of screening and detecting CH subjects, stricter implementation of a structured system for monitoring and surveillance is needed to promote the management of patients and to reduce rates of loss to follow-up. Determining and addressing the causes of high false positive rates must be prioritised.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/archdischild-2017-313720","type":"journal-article","created":{"date-parts":[[2018,3,14]],"date-time":"2018-03-14T12:20:46Z","timestamp":1521030046000},"page":"F176-F181","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Evaluation of the congenital hypothyroidism screening programme in Iran: a 3-year retrospective cohort study"],"prefix":"10.1136","volume":"104","author":[{"given":"Ladan","family":"Mehran","sequence":"first","affiliation":[{"name":"Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, The Islamic Republic of Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davood","family":"Khalili","sequence":"additional","affiliation":[{"name":"Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, The Islamic Republic of Iran"},{"name":"Department of Biostatistics and Epidemiology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, The Islamic Republic of Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahin","family":"Yarahmadi","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolic Office, Center for Disease Control, Ministry of Health and Medical Education, Tehran, The Islamic Republic of Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossein","family":"Delshad","sequence":"additional","affiliation":[{"name":"Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, The Islamic Republic of Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yadollah","family":"Mehrabi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, The Islamic Republic of Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atieh","family":"Amouzegar","sequence":"additional","affiliation":[{"name":"Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, The Islamic Republic of Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasrin","family":"Ajang","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolic Office, Center for Disease Control, Ministry of Health and Medical Education, Tehran, The Islamic Republic of Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fereidoun","family":"Azizi","sequence":"additional","affiliation":[{"name":"Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, The Islamic Republic of Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,3,14]]},"reference":[{"key":"2025090513143228000_104.2.F176.1","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1586\/17446651.2014.911083","article-title":"The changing epidemiology of congenital hypothyroidism: fact or artifact?","volume":"9","author":"Delado\u00eby","year":"2014","journal-title":"Expert Rev Endocrinol Metab"},{"key":"2025090513143228000_104.2.F176.2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-1073"},{"key":"2025090513143228000_104.2.F176.3","doi-asserted-by":"crossref","first-page":"480","DOI":"10.26719\/2002.8.4-5.480","article-title":"Screening for congenital hypothyroidism in the Islamic Republic of Iran: strategies, obstacles and future perspectives","volume":"8","author":"Ordookhani","year":"2002","journal-title":"East Mediterr Health J"},{"key":"2025090513143228000_104.2.F176.4","first-page":"92","article-title":"Outcome of congenitally hypothyroid screening program in isfahan: iran from prevention to treatment","volume":"1","author":"Hashemipour","year":"2010","journal-title":"Int J Prev Med"},{"key":"2025090513143228000_104.2.F176.5","doi-asserted-by":"crossref","first-page":"76","DOI":"10.4103\/2008-7802.162952","article-title":"Spatial Analysis of Neonatal Congenital Hypothyroidism and Nitrate as an Environmental Pollutant in Isfahan Province During 2010-2013","volume":"6","author":"Mehrnejat","year":"2015","journal-title":"Int J Prev Med"},{"key":"2025090513143228000_104.2.F176.6","unstructured":"Therrell BL , David-Padilla C . 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