Introduction: Breast-feeding is a major cause of prolonged non-hemolytic jaundice and may disguise other important causes such hypothyroidism. The aim of this study was to evaluate the frequency of congenital hypothyroidism (CH) in neonates with prolonged jaundice in an area without a hypothyroid screening program but high breastfeeding rate.
Methods: Jaundiced, otherwise clinically well infants more than 2 weeks of age with complaint of visible yellow color of skin or eye, brought or referred to the Newborn Nursery of Imam Hospital, Urumieh Inin, for evaluation' of prolonged jaundice were included in this study between April 2005 and March 2006. Work-up of prolonged indirect hyperbilirubinemia including direct Coombs test, blood types of infant and mother, complete blood count, blood smear, glucose-6-phosphate dehydrogenase level, reticulocyte, bilirubin level, T4, TSH and urine analysis and culture were performed.
Results: All cases were breastfed. Forty-three male infants (43%) and 57 female infants (57%) were studied. Among 10.0.neonates enrolled in the study, 6 (6%) suffered from CH; 2 of these were male and the rest female.
Conclusions: The frequency of CH is high in prolonged jaundice in the area where the study was conducted. Based on the results, we recommend that CH be aggressively investigated in breast-fed infants in regions without a hypothyroid screening program, but high breastfeeding rate.