Screening for congenital hypothyroidism in the Islamic Republic of Iran: strategies, obstacles and future perspectives.

The operational feasibility of a congenital hypothyroidism (CH) screening programme was assessed. Cord blood spot specimens were collected at seven Teheran hospitals and within the Damavand District health network. Cord thyroid-stimulating hormone (TSH) levels > or = 20 mU/L were recalled and levothyroxine (L-T4) therapy was started immediately after diagnosis of CH. Of 20,107 acceptable specimens, 22 neonates had CH (1:914 births). The recall rate was 1.3%. Screening coverage was 90% of live births. Of all cord samples, only 0.2% were unacceptable either because of delay in transportation or improper specimen collection. Median ages at the time of diagnosis and starting treatment were 12 and 8 days respectively. Screening for CH is feasible and a national screening programme is a necessity.