Determining Reference Ranges for Total T4 in Dried Blood Samples for Newborn Screening

Anna-Isabella Hijman; Daniel Konrad; Ralph Fingerhut

doi:10.3390/ijns6010017

Determining Reference Ranges for Total T₄ in Dried Blood Samples for Newborn Screening

Int J Neonatal Screen. 2020 Mar 4;6(1):17. doi: 10.3390/ijns6010017. eCollection 2020 Mar.

Authors

Anna-Isabella Hijman¹, Daniel Konrad², Ralph Fingerhut³

Affiliations

¹ University Children's Hospital Zurich, 8032 Zurich, Switzerland.
² Department of Endocrinology & Diabetology, Children's Research Center, University Children's Hospital Zurich, 8032 Zurich, Switzerland.
³ Swiss Newborn Screening Laboratory, Children's Research Center, University Children's Hospital Zurich, 8032 Zurich, Switzerland.

Abstract

The purpose of this study was to define reference intervals for total thyroxine (tT₄) in dried blood samples (DBSs) obtained for newborn screening. The aim of our study was to assess the possible benefit of measuring tT₄ concentrations directly in DBSs obtained for newborn screening in premature and term-born infants. In order to have a sufficient number of samples for the extremely premature infants (<30 weeks), we set up a retrospective study, measuring the concentrations in DBSs collected over the previous 21 weeks. This time frame was a result of the included miniature study of tT₄ stability in DBSs. We found that tT₄ strongly correlated with gestational age (GA) in premature infants, highlighting the need for age-specific reference ranges. For term-born infants, the tT₄ ranges did not vary significantly among different gestational ages, allowing for the use of one single reference range.

Keywords: congenital hypothyroidism (CH); dried blood sample (DBS); newborn screening; prematurity; reference range; thyroid stimulating hormone (TSH); thyroxine stability; total thyroxine (tT4).