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Published on: June 6, 2014
Congenital hypothyroidism: etiology and growth-development outcome
Setila Dalili1, Seyed Mahmood Rezvani2, Hossein Dalili3
1Pediatrics Growth Disorders Research Center, 17 Shahrivar Hospital, Faculty of Medicine, Guilan University of Medical Sciences, Guilan, Iran. setiladalili1346@yahoo.com.
Insights
Neonatal screening and early treatment of congenital hypothyroidism (CH) lead to normal growth and development in children. This study in Iran found CH incidence at 1:781, with most cases being transient and effectively managed.
Area of Science:
- Pediatrics
- Endocrinology
- Public Health
Background:
- Congenital hypothyroidism (CH) is a leading preventable cause of intellectual and growth deficits.
- Early detection and management are crucial for optimal outcomes in affected neonates.
Purpose of the Study:
- To investigate the growth and mental outcomes of children diagnosed with congenital hypothyroidism.
- To determine the incidence and etiological factors of CH in Guilan province, Iran.
Main Methods:
- Screening of 28,904 neonates for CH between November 2006 and November 2007.
- Etiological evaluation using laboratory tests, thyroid sonography, or scan.
- Comparison of growth and developmental parameters (height, weight, head circumference, IQ) at four years of age with a control group.
Main Results:
- CH incidence was 1:781 live births, with 54% female and 46% male cases.
- Transient hypothyroidism (56.8%) was more common than permanent CH (43.2%).
- Permanent CH cases were primarily due to dyshormonogenesis (68.2%) or thyroid dysgenesis (31.2%).
- A positive family history of thyroid disease was significantly higher in CH patients (34.3%) versus controls (13.2%, P=0.03).
- No significant differences in demographic characteristics or IQ were observed between CH patients and controls.
- Treated CH patients demonstrated normal growth, indicating effective screening and treatment protocols.
Conclusions:
- Neonatal screening and timely treatment of congenital hypothyroidism result in normal growth and development.
- The screening program in Guilan province is effective in identifying and managing CH.
- Family history is a significant risk factor for congenital hypothyroidism.
Abstract:
One of the most preventable causes of mental and growth retardation is congenital hypothyroidism (CH). This study tries to investigate growth and mental outcome of patients with CH. Since November 2006 and November 2007 in Guilan province, north of Iran, all neonates who were diagnosed with CH, evaluated for etiology of CH by laboratory follow up, thyroid sonography or scan. Growth and development of patients with CH were compared with healthy children in same age, geographical area, social and economical classes in four years old. Demographic characteristics including height, weight, and head circumference at birth, follow up time (four years old) and IQ (Good enough test) were recorded in questionnaires. Among 28904 screened neonates, 37 patients with CH were diagnosed. Incidence of CH was 1:781 in live births, 20 (54%) in female neonates and 17 (46%) in male neonates. The incidences of permanent and transient hypothyroidism were 43.2% (16 cases) and 56. 8% (21 cases) respectively. The incidence of permanent and transient hypothyroidism were 16 (43.2%) and 21 (56, 8%), respectively. In permanent CH, 11 cases (%.68.2) had dyshormonogenesis and 5 cases (%.31.2) had thyroid dysgenesis. Significant statistical difference was only in family history of thyroid disease (34, 3% Positive family history in CH vs. 13.2% in control group, P-value 0.03). All other demographic characteristics and IQ had no statistical difference. Patients with CH diagnosed through neonatal screening and treated had normal growth as general population that indicates effective screening program and treatment in this area (3.2%).
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