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Growth in children with congenital hypothyroidism detected by neonatal screening
R Aronson1, R M Ehrlich, J D Bailey
1Department of Pediatrics and Psychology, Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Children with congenital hypothyroidism showed normal growth patterns when thyroxine levels were maintained in the upper normal range. Early hypothyroidism duration inversely correlated with height, suggesting long-term growth impacts.
Area of Science:
- Pediatrics
- Endocrinology
- Growth and Development
Background:
- Congenital hypothyroidism (CH) is a condition requiring lifelong management.
- Understanding the long-term physical growth outcomes in children with CH is crucial for optimizing treatment strategies.
Purpose of the Study:
- To prospectively analyze the physical growth of children with CH.
- To compare growth parameters (height, weight, head circumference) and skeletal maturation with population standards.
- To investigate the correlation between the duration of hypothyroidism and attained height.
Main Methods:
- Prospective analysis of 56 children diagnosed with CH.
- Comparison of height, weight, and head circumference percentiles against population norms.
- Assessment of skeletal maturation using bone age and prediction of adult height.
- Correlation analysis between duration of intrauterine/postnatal hypothyroidism and height up to 9 years.
Main Results:
- Children with CH exhibited higher mean percentiles for height and head circumference than population means.
- Bone age scores were slightly elevated, but adult height predictions were not significantly different from midparental height or population means.
- Longer durations of both intrauterine and postnatal hypothyroidism were inversely correlated with height attained by age 9.
Conclusions:
- Early and prolonged hypothyroidism may have a lasting impact on physical growth in children.
- Maintaining serum thyroxine levels in the upper half of the normal range is associated with normal growth patterns in children with CH.
- Optimized thyroxine replacement therapy is key to achieving normal growth outcomes in congenital hypothyroidism.
Abstract:
A prospective analysis of physical growth in 56 children with congenital hypothyroidism compared the children's height, weight, and head circumference with population percentiles. Two measures of skeletal maturation and predictions of adult height were also compared with population standards. The mean percentiles for the children's height and head circumference were higher than population means. Although mean bone age scores were slightly higher, predictions of adult height did not differ significantly from midparental height (arithmetic mean of sum of parental heights) and population means. The duration of intrauterine hypothyroidism as measured by gestational bone age and the duration of postnatal hypothyroidism were inversely correlated with heights attained up to 9 years. This association suggests a possible long-term influence of early hypothyroidism on growth. In children with congenital hypothyroidism, maintenance of serum thyroxine levels in the upper half of the normal range results in normal growth patterns.