Neonatal thyrotropin (TSH) screening as a tool for monitoring iodine nutrition in Armenia

Background Neonatal thyrotropin (TSH) is influenced not only by the infant's own thyroid function, but also by maternal thyroid status, and can thus provide a general index of thyroid health in the community. Methods In 2012, the Republic of Armenia implemented a program of universal neonatal hypothyroidism screening by means of measuring the serum TSH level. The Arabkir Medical Center in Yerevan, Armenia, has maintained records of neonatal TSH screening data comprising nearly 100% of all births in Armenia from 2012 through 2016. We analyzed these data to determine the frequency of neonatal TSH levels higher than the cut point of 5 mIU/L, indicative of sufficient iodine nutrition status, and to detect any time dependence over years or regional variation. Results A total of 127,177 records from 2012 to 2016 were included. The geographic distribution of neonatal TSH records was reflective of the population of Armenia; the national percentage of records over 5 mIU/L ranged from a high of 2.88% in 2012 to a low of 1.71% in 2016. Minimal regional variation was noted, from a 2012-2016 cumulative high of 2.93% of records over 5 mIU/L in Shirak province to a low of 0.95% in the Vayots Dzor province. Conclusions From all years and from all regions, values were consistently and uniformly below the cut point of 5 mIU/L. These results show no evidence of iodine deficiency in Armenia, and suggest that neonatal TSH may be a useful tool for monitoring iodine nutrition in Armenia.