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Relation between Early Over- and Undertreatment and Behavioural Problems in Preadolescent Children with Congenital

Jacoba J Bongers-Schokking1, Wilma C M Resing2, Wilma Oostdijk3

  • 1Department of Pediatrics, Erasmus MC - Sophia Children's Hospital , University Medical Center Rotterdam, Rotterdam, The Netherlands.

Hormone Research in Paediatrics
|November 9, 2018
PubMed

Insights

Early overtreatment of congenital hypothyroidism (CH) may lead to attention problems, while undertreatment is linked to autism spectrum disorder in children. This study highlights the critical balance needed for CH treatment.

Area of Science:

  • Pediatric Endocrinology
  • Developmental Psychology
  • Neuroscience

Background:

  • Congenital hypothyroidism (CH) can cause developmental issues if untreated.
  • Overtreatment of CH may be associated with attention deficits.
  • Undertreatment of CH might lead to behavioral problems like cretinism.

Purpose of the Study:

  • To investigate the long-term behavioral effects of overtreatment and undertreatment in children with CH.
  • To determine the association between specific treatment imbalances and neurodevelopmental outcomes.

Main Methods:

  • Prospective follow-up of 55 CH patients from birth to 11 years.
  • Utilized Child Behaviour Checklist and Teacher's Report Form at ages 6 and 11.
  • Defined overtreatment/undertreatment based on free thyroxine (fT4) levels relative to individual steady-state concentrations.

Main Results:

  • Children overtreated in the first 1-3 months postnatally showed higher Attention, Delinquency, and Aggression (ADA) scores at ages 6 and 11.
  • Patients with severe CH undertreated from 3-6 months postnatally had elevated Withdrawn, Anxious, Social, and Thought (WAST) scores at ages 6 and 11.

Conclusions:

  • Early overtreatment of CH is potentially linked to attention deficit hyperactivity disorder (ADHD).
  • Early undertreatment of CH may be associated with autism spectrum disorder (ASD).
  • This study provides novel evidence for the impact of CH treatment timing on neurodevelopmental outcomes.
Abstract

Keywords:
ADHDAutismCongenital hypothyroidismEarly overtreatmentEarly undertreatmentfT4 steady state concentrations

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