Comparative Analysis of Hyperbilirubinemia Between Congenital Hypothyroidism and Euthyroidism in Neonates in Rawalpindi, Pakistan.

INTRODUCTION

Neonatal hyperbilirubinemia is a prevalent clinical observation that, if persistent or severe, may suggest underlying endocrine abnormalities such as congenital hypothyroidism (CH). Thyroid hormones play a crucial role in liver function and the metabolism of bilirubin.

OBJECTIVE

This study aimed to evaluate blood bilirubin and thyroid stimulating hormone (TSH) levels in neonates diagnosed with CH compared to those with normal thyroid function (euthyroid).

MATERIAL AND

METHODS

A comparative cross-sectional observational study was conducted at Majeed Medical & Gynae Complex and Farid Medical Family Hospital in Rawalpindi, Pakistan. A total of 200 neonates, aged 1-30 days, were included in the study, comprising 100 confirmed cases of CH and 100 controls. The clinical features and demographics of patients were recorded using a structured interview questionnaire. Serum bilirubin and TSH levels were measured using automated Roche analyzers (C-311 and E-411). Data were analyzed utilizing IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, New York, United States) and GraphPad Prism (Dotmatics, Boston, Massachusetts, United States).

RESULTS

Prolonged jaundice was the most prevalent (74%) clinical finding among the CH group. Mean bilirubin (total, direct, and indirect) levels and TSH levels were analyzed using an independent t-test, with a significance threshold set at p < 0.01. A positive significant correlation exists between TSH levels and bilirubin (total and indirect) concentration in the hypothyroid group, with a p-value of < 0.01. These findings highlight the clinical significance of timely newborn TSH screening and the early administration of levothyroxine to mitigate jaundice-related morbidity and prevent unnecessary phototherapy or extended hospitalization.

CONCLUSION

The current study concludes that newborns with CH have markedly increased all types of bilirubin levels relative to euthyroid newborns, and there is a statistically significant positive correlation between TSH levels and bilirubin levels (total and indirect).