{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T09:13:41Z","timestamp":1777886021164,"version":"3.51.4"},"reference-count":13,"publisher":"Journal of the ASEAN Federation of Endocrine Societies (JAFES)","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J ASEAN Fed Endocr Soc"],"abstract":"<jats:p>Objectives. This study aimed to determine the prevalence of congenital hypothyroidism (CH) among newborns in Ninh Binh Province, Vietnam, and to evaluate whether adding a second thyroid-stimulating hormone (TSH) screening reduces false positives and improves diagnostic accuracy compared with the traditional single-step screening commonly practiced in Vietnam.\nMethodology. A retrospective cohort study was conducted on 11,306 newborns screened between January 2019 and December 2020. TSH levels were measured from dried blood spot samples, with a threshold of &gt;9 mU\/L indicating high risk. High-risk cases underwent a second screening, followed by confirmation with serum TSH and free thyroxine. Screening performance (sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV]) and risk factors for CH were analyzed.\nResults. The prevalence of high-risk CH was 2.40% (271\/11,306 newborns), with four confirmed cases (incidence: 1:2,826). The two-step screening program achieved a sensitivity of 75.00%, with one false-negative case later detected clinically. Specificity improved from 97.64% in the first screening to 99.81% in the second, while PPV increased more than tenfold (1.11% \u2192 11.54%). Low birth weight infants (\u22642,500 g) had a significantly higher CH risk (OR: 10.04, 95% CI: 1.053\u201395.820, p = 0.004).\nConclusions. This first provincial evaluation of two-step CH screening in Vietnam demonstrated that repeat testing significantly reduced false positives and improved diagnostic accuracy without compromising sensitivity. The findings highlight the value of implementing a two-step strategy to optimize newborn screening, reduce unnecessary referrals and save resources in developing countries.<\/jats:p>","DOI":"10.15605\/jafes.041.01.5795","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T03:21:57Z","timestamp":1777605717000},"source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Two-Step TSH Screening Protocol for Congenital Hypothyroidism:"],"prefix":"10.15605","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5216-2282","authenticated-orcid":false,"given":"Nguyen","family":"Hoang Viet","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tran Khanh","family":"Hoa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0051-8283","authenticated-orcid":false,"given":"Nguyen Bich","family":"Ngan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bu Thi","family":"Bao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nguyen Anh","family":"Ngoc","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6947-9043","authenticated-orcid":false,"given":"Van-Thao","family":"Ta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6244","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"84800","doi-asserted-by":"crossref","unstructured":"Rose SR, Wassner AJ, Wintergerst KA, et al. Congenital hypothyroidism: Screening and management. Pediatrics. 2023;151(1):e2022060419. https:\/\/pubmed.ncbi.nlm.nih.gov\/36827523\/ https:\/\/doi.org\/10.1542\/peds.2022-060419","DOI":"10.1542\/peds.2022-060419"},{"key":"84801","doi-asserted-by":"crossref","unstructured":"van Trotsenburg P, Stoupa A, L\u00e9ger J, et al. Congenital hypothyroidism: A 2020-2021 consensus guidelines update\u2014An ENDO-European reference network initiative endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology. Thyroid. 2021;31(3):387-419. https:\/\/pubmed.ncbi.nlm.nih.gov\/33272083\/ https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8001676\/ https:\/\/doi.org\/10.1089\/thy.2020.03333","DOI":"10.1089\/thy.2020.0333"},{"key":"84802","doi-asserted-by":"crossref","unstructured":"Vamja R, M Y, Patel M, et al. Impact of maternal thyroid dysfunction on fetal and maternal outcomes in pregnancy: A prospective cohort study. Clin Diabetes Endocrinol. 2024;10(1):50. https:\/\/pubmed.ncbi.nlm.nih.gov\/39695884\/ https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC11658447\/ https:\/\/doi.org\/10.1186\/s40842-024-00212-6","DOI":"10.1186\/s40842-024-00212-6"},{"key":"84803","doi-asserted-by":"crossref","unstructured":"Rastogi MV, LaFranchi SH. Congenital hypothyroidism. Orphanet J Rare Dis. 2010;5:17. https:\/\/pubmed.ncbi.nlm.nih.gov\/20537182\/","DOI":"10.1186\/1750-1172-5-17"},{"key":"84804","doi-asserted-by":"crossref","unstructured":"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2903524\/ https:\/\/doi.org\/10.1186\/1750-1172-5-17","DOI":"10.1186\/1750-1172-5-17"},{"key":"84805","unstructured":"International Atomic Energy Agency. Screening of newborns for congenital hypothyroidism: Guidance for developing programmes. Vienna: International Atomic Energy Agency; 2005. https:\/\/www-pub.iaea.org\/MTCD\/Publications\/PDF\/Pub1234_web.pdf"},{"key":"84806","doi-asserted-by":"crossref","unstructured":"Di\u1ec7p TTL, B\u00f9i PT, Nguy\u1ec5n NK, V\u0169 CD. Screening results for congenital hypothyroidism at the Vietnam National Children\u2019s Hospital. Vietnam Med J. 2022;509(1):32-5. https:\/\/doi.org\/10.51298\/vmj.v509i1.1690","DOI":"10.51298\/vmj.v509i1.1690"},{"key":"84807","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Rose SR, Brown RS, et al. Update of newborn screening and therapy for congenital hypothyroidism. Pediatrics. 2006;117(6):2290-303. https:\/\/pubmed.ncbi.nlm.nih.gov\/16740880\/ https:\/\/doi.org\/10.1542\/peds.2006-0915","DOI":"10.1542\/peds.2006-0915"},{"key":"84808","doi-asserted-by":"crossref","unstructured":"Kanike N, Davis A, Shekhawat PS. Transient hypothyroidism in the newborn: To treat or not to treat. Transl Pediatr. 2017;6(4):349-58. https:\/\/pubmed.ncbi.nlm.nih.gov\/29184815\/ https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5682382\/ https:\/\/doi.org\/10.21037\/tp.2017.09.07 Zhao Z, Shi H, Wen Y, Xu H. Incidence and associated risk factors of congenital hypothyroidism among newborns in Hainan, China: A retrospective study. J Pediatr Endocrinol Metab. 2024;37(8):709-14. https:\/\/pubmed.ncbi.nlm.nih.gov\/38910317\/ https:\/\/doi.org\/10.1515\/jpem-2023-0571","DOI":"10.21037\/tp.2017.09.07"},{"key":"84809","doi-asserted-by":"crossref","unstructured":"Pineda-Sanabria P, Portilla-Rojas E, Le\u00f3n-Sanabria MC, et al. Congenital hypothyroidism in Bogot\u00e1, Colombia: A current description (2015-2021). J Pediatr Endocrinol Metab. 2023;36(8):772-6. https:\/\/pubmed.ncbi.nlm.nih.gov\/37469167\/","DOI":"10.1515\/jpem-2023-0150"},{"key":"84810","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1515\/jpem-2023-0150","DOI":"10.1515\/jpem-2023-0150"},{"key":"84811","doi-asserted-by":"crossref","unstructured":"Kahssay M, Ngwiri T. High yield of congenital hypothyroidism among infants attending Children Hospital, Nairobi, Kenya: A facility-based study in the absence of newborn screening. J Pediatr Endocrinol Metab. 2024;38(1):51-7. https:\/\/pubmed.ncbi.nlm.nih.gov\/39570906\/ https:\/\/doi.org\/10.1515\/jpem-2024-0219","DOI":"10.1515\/jpem-2024-0219"},{"key":"84812","doi-asserted-by":"crossref","unstructured":"Valizadeh M, Moezzi F, Khavassi Z, et al. Influence of topical iodine-containing antiseptics used during delivery on recall rate of congenital hypothyroidism screening program. J Pediatr Endocrinol Metab. 2017;30(9):973-8. https:\/\/pubmed.ncbi.nlm.nih.gov\/28809751\/ https:\/\/doi.org\/10.1515\/jpem-2016-0164","DOI":"10.1515\/jpem-2016-0164"}],"container-title":["Journal of the ASEAN Federation of Endocrine Societies"],"original-title":[],"link":[{"URL":"https:\/\/asean-endocrinejournal.org\/index.php\/JAFES\/article\/download\/5795\/5325","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/asean-endocrinejournal.org\/index.php\/JAFES\/article\/download\/5795\/5325","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T03:22:14Z","timestamp":1777605734000},"score":1,"resource":{"primary":{"URL":"https:\/\/asean-endocrinejournal.org\/index.php\/JAFES\/article\/view\/5795"}},"subtitle":["Prevalence and Diagnostic Accuracy in Ninh Binh, Vietnam"],"short-title":[],"issued":{"date-parts":[[2026,4,23]]},"references-count":13,"URL":"https:\/\/doi.org\/10.15605\/jafes.041.01.5795","relation":{},"ISSN":["2308-118X","0857-1074"],"issn-type":[{"value":"2308-118X","type":"electronic"},{"value":"0857-1074","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4,23]]}}}