{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:50:12Z","timestamp":1783486212901,"version":"3.55.0"},"reference-count":47,"publisher":"American Academy of Pediatrics (AAP)","issue":"Supplement_2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,5,1]]},"abstract":"<jats:p>The reported incidence rate of primary congenital hypothyroidism (CH) has been increasing in the United States over the past 2 decades. We have considered the possibility that the inclusion of cases of transient hypothyroidism has inflated the reported incidence rate of CH. Assessing the effects of cases of transient hypothyroidism on the incidence rate is problematic, because the definitions, diagnostic criteria, and differentiation from transient hyperthyrotropinemia vary widely among state newborn screening programs. Among the 4 etiologies for transient hypothyroidism (maternal thyrotropin receptor\u2013blocking antibodies, exposure to maternal antithyroid medications, iodine deficiency, and iodine excess), there is little evidence of increases in the incidence rate from thyrotropin receptor\u2013blocking antibodies. Exposure to antithyroid drugs could contribute significantly to the incidence rate of transient CH, given the high estimated incidence of active maternal hyperthyroidism. Iodine deficiency or excess in the United States seems unlikely to have contributed significantly to the incidence rate of CH, because the secular trend toward lower iodine intake among women of reproductive age in the 1980s and 1990s seems to have plateaued, and perinatal iodine exposure has presumably declined as a result of recommendations to discontinue using iodine-containing disinfectants. Although the female-to-male sex ratio among newborns with thyroid agenesis or dysgenesis (the most common causes of CH) is typically 2:1, analysis of the sex ratio of newborns diagnosed with presumed CH in the United States suggests that a substantial proportion might have transient hypothyroidism or hyperthyrotropinemia, because the sex ratio has been well below the expected 2:1 ratio. Combined ultrasonography and 123I scintigraphy of the thyroid gland are effective tools for identifying cases of thyroid agenesis and dysgenesis and can help to differentiate cases of transient hypothyroidism from true CH. Imaging is also a vital component in evaluating children who, at 3 years of age, undergo a trial of discontinuation of levothyroxine treatment to test for persistence of hypothyroidism. Ultimately, thyroid gland imaging, in conjunction with long-term follow-up studies that appropriately assess and report whether there was permanence of hypothyroidism, will be necessary to address the true incidence rate of CH and any contribution to the observed rate by transient cases of hypothyroidism or hyperthyrotropinemia.<\/jats:p>","DOI":"10.1542\/peds.2009-1975f","type":"journal-article","created":{"date-parts":[[2010,4,30]],"date-time":"2010-04-30T15:08:20Z","timestamp":1272640100000},"page":"S54-S63","source":"Crossref","is-referenced-by-count":74,"title":["The Impact of Transient Hypothyroidism on the Increasing Rate of Congenital Hypothyroidism in the United States"],"prefix":"10.1542","volume":"125","author":[{"given":"John S.","family":"Parks","sequence":"first","affiliation":[{"name":"Division of Pediatric Endocrinology, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D.","family":"Grosse","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia F.","family":"Hinton","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Drummond-Borg","sequence":"additional","affiliation":[{"name":"Department of State Health Services, Austin, Texas;"},{"name":"Cook Children's Physician Network, Fort Worth, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynette","family":"Borgfeld","sequence":"additional","affiliation":[{"name":"Department of State Health Services, Austin, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin M.","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Rollins School of Pubic Health, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2010,5,1]]},"reference":[{"issue":"3","key":"2021120821244925800_B1","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.ymgme.2007.03.012","article-title":"Increase in congenital hypothyroidism in New York State and in the United States","volume":"91","author":"Harris","year":"2007","journal-title":"Mol Genet Metab"},{"key":"2021120821244925800_B2","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.1542\/peds.2009-1975C","article-title":"Prevalence of congenital hypothyroidism\u2014current trends and future directions: workshop summary","volume":"125","author":"Olney","year":"2010","journal-title":"Pediatrics"},{"key":"2021120821244925800_B3","doi-asserted-by":"crossref","first-page":"S37","DOI":"10.1542\/peds.2009-1975D","article-title":"Trends in incidence rates of congenital hypothyroidism related to select demographic factors: data from the United States, California, Massachusetts, New York, and Texas","volume":"125","author":"Hinton","year":"2010","journal-title":"Pediatrics"},{"issue":"6","key":"2021120821244925800_B4","doi-asserted-by":"crossref","first-page":"2290","DOI":"10.1542\/peds.2006-0915","article-title":"Update of newborn screening and therapy for congenital hypothyroidism","volume":"117","author":"American Academy of Pediatrics, Section on Endocrinology and Committee on Genetics","year":"2006","journal-title":"Pediatrics"},{"issue":"3","key":"2021120821244925800_B5","first-page":"1147","article-title":"Incidence of transient congenital hypothyroidism due to maternal thyrotropin receptor-blocking antibodies in over one million babies","volume":"81","author":"Brown","year":"1996","journal-title":"J Clin Endocrinol Metab"},{"issue":"7","key":"2021120821244925800_B6","doi-asserted-by":"crossref","first-page":"3209","DOI":"10.1210\/jcem.87.7.8662","article-title":"Subclinical hypothyroidism in early childhood: a frequent outcome of transient neonatal hyperthyrotropinemia","volume":"87","author":"Calaciura","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2021120821244925800_B7","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S0022-3476(00)90049-0","article-title":"Three-year follow-up of borderline congenital hypothyroidism","volume":"136","author":"Daliva","year":"2000","journal-title":"J Pediatr"},{"issue":"3","key":"2021120821244925800_B8","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1515\/JPEM.2003.16.3.375","article-title":"The differing outcomes of hyperthyrotropinaemia","volume":"16","author":"Cody","year":"2003","journal-title":"J Pediatr Endocrinol Metab"},{"issue":"5","key":"2021120821244925800_B9","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.jpeds.2004.02.020","article-title":"Definitive diagnosis in children with congenital hypothyroidism","volume":"144","author":"Eugster","year":"2004","journal-title":"J Pediatr"},{"issue":"6","key":"2021120821244925800_B10","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1530\/eje.1.02048","article-title":"Risk factors for congenital hypothyroidism: results of a population case-control study (1997\u2013 2003)","volume":"153","author":"Medda","year":"2005","journal-title":"Eur J Endocrinol"},{"issue":"8","key":"2021120821244925800_B11","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1136\/adc.2005.088427","article-title":"Improvement in screening performance and diagnosis of congenital hypothyroidism in Scotland 1979\u20132003","volume":"91","author":"Jones","year":"2006","journal-title":"Arch Dis Child"},{"key":"2021120821244925800_B12","unstructured":"National Newborn Screening Information System. 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