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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Increasing prevalence of congenital hypothyroidism emerges as a growing concern in Jordan
Manar Al-Lawama, Rasha Odeh, Abeer AlAssaf, Jumana Albaramki, Nour Ghanem, Dina Abu Assab, Aseel Al-Dmour, Esraa Arabiat, Arwa Kiswani, Salam Al-Kayed, Hadeel Alzoubi, Saleh Al Jbour
Manar Al-Lawama, Rasha Odeh, Abeer AlAssaf, Jumana Albaramki, Esraa Arabiat, Salam Al-Kayed, Department of Pediatrics, The University of Jordan, Amman 11940, Amman, Jordan
Nour Ghanem, Department of Pediatrics, Al-Balqa` Applied University, Salt 19117, Salt, Jordan
Dina Abu Assab, Hadeel Alzoubi, Department of Pediatrics, Istishari Hospital, Amman 11942, Amman, Jordan
Aseel Al-Dmour, Department of Pediatrics, Mutah University, Al Karak 61710, Jordan
Arwa Kiswani, Department of Pediatrics, King Hussain Cancer Center, Amman 11941, Amman, Jordan
Saleh Al Jbour, Department of Surgery, Royal Medical services, Amman 11855, Amman, Jordan
Author contributions: Al-Lawama M contributed to conceptualization, study design, data analysis, and manuscript writing; Odeh R and AlAssaf A contributed to clinical input, analysis, and manuscript review; Odeh R, AlAssaf A and Albaramki J contributed to final approval; Albaramki J, Ghanem N, Abu Assab D, Al-Dmour A, Arabiat E, Kiswani A, Al-Kayed S, Alzoubi H and Al Jbour S contributed to literature review; Ghanem N, Abu Assab D, Al-Dmour A, Arabiat E, Kiswani A, Al-Kayed S and Alzoubi H contributed to preliminary analysis and manuscript draft writing; Al Jbour S contributed to approval of the final manuscript.
Institutional review board statement: Ethical approval was obtained from the Deanship of Scientific Research at the University of Jordan and the Institutional Review Board Committee at the University of Jordan Hospital.
Informed consent statement: The study is a retrospective anonymized file review. The consent is waived.
Conflict-of-interest statement: All authors declare no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Manar Al-Lawama, MD, Professor, Department of Pediatrics, The University of Jordan, Queen Rania Street, Amman 11940, Amman, Jordan.
m.allawama@ju.edu.jo
Received: April 7, 2025
Revised: May 21, 2025
Accepted: June 17, 2025
Published online: December 9, 2025
Processing time: 208 Days and 17.3 Hours
BACKGROUND
Congenital hypothyroidism (CH) is a prevalent childhood endocrine disorder associated with irreversible neurological consequences. Its global incidence is on the rise.
AIM
To estimate CH incidence in Jordan and assess the potential utility of incorporating (fT4) measurements into the screening process.
METHODS
This retrospective analysis examined thyroid function test results for infants born at our center between 2016 and 2020. Infants born before 28 weeks and those screened after 14 days of life were excluded. Screening occurred between days 3 and 7 of life, and thyroid-stimulating hormone (TSH) and T4 levels were measured concurrently from peripheral venipuncture blood samples. A TSH cutoff of < 5 mIU/L was considered normal. Values between 5 and 20 mIU/L were equivocal, requiring repeat tests. TSH levels exceeding 20 mIU/L were considered critical.
RESULTS
A total of 10521 infants were included in the study, and 26 were diagnosed with CH, yielding an incidence of 1 in 400 live births. Females constituted 57.7% of CH cases. All CH cases had initial TSH values exceeding 5.0 mIU/L, with clustering above 20 mIU/L. Six CH infants had Down syndrome, accounting for 23.1% of CH cases.
CONCLUSION
Our study revealed a high incidence of CH in Jordan, marking a significant increase from previously reported rates. We recommend a national study to investigate risk factors and underlying causes of CH in our population. Furthermore, we advocate for the use of TSH alone with a cutoff value of < 5 mIU/L for screening purposes.
Core Tip: This study reveals a high incidence of congenital hypothyroidism (1 in 400 live births) in Jordan, a significant increase from previously reported rates. It emphasizes the importance of TSH screening with a cutoff of < 5 mU/L and advocates for further investigation into the underlying causes and risk factors for CH in the Jordanian population.
