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Physical and mental growth and development in children with congenital hypothyroidism: a case-control study
Javad Nazari1, Kimia Jafari2, Maryam Chegini2
1Department of Pediatrics, Medical School, Arak University of Medical Sciences, Arak, Iran.
Insights
Newborn screening for congenital hypothyroidism is highly effective, significantly reducing developmental differences in children. Early diagnosis improves quality of life and lowers long-term healthcare costs.
Area of Science:
- Pediatrics
- Endocrinology
- Developmental Biology
Background:
- Congenital hypothyroidism (CH) can lead to subtle, often irreversible, brain disorders if not detected early.
- Clinical complications of CH are typically not apparent in infancy, making diagnosis difficult without screening.
- Newborn screening programs are crucial for early detection and intervention in CH.
Purpose of the Study:
- To compare the physical and mental growth patterns of children with congenital hypothyroidism to those of healthy children.
- To evaluate the long-term developmental outcomes in children diagnosed with CH through newborn screening.
Main Methods:
- A case-control study involving 34 CH patients and 68 matched healthy controls.
- Utilized developmental assessments including the Ages and Stages Questionnaire (ASQ), Bayley Scales of Infant Development, and Wechsler scales (WPPSI).
- Emotional and social development was assessed using the ASQ-SE, with data analyzed using STATA.
Main Results:
- No significant differences in verbal, non-verbal, or general IQ between CH patients and controls.
- No significant differences in ASQ test ranges (communication, motor, problem-solving, social) at 12 and 42 months.
- While cognitive and expressive development showed no significant differences, CH patients exhibited significant differences in perceptual, gross motor, and fine motor skills.
Conclusions:
- Neonatal screening for CH is highly effective in mitigating developmental disparities.
- Early diagnosis and treatment of CH significantly improve patient quality of life.
- Effective CH screening programs reduce long-term healthcare system costs.
Introduction:
The clinical complications of congenital hypothyroidism such as brain disorders are very subtle and are not recognizable in infancy period. They are recognizable when it is too late for treatment or prevention. General screening of newborns is effective in diagnosing congenital hypothyroidism and initiating initial treatment. The aim of this study is to compare the physical and mental growth pattern of children with congenital hypothyroidism with healthy ones.
Methods:
This case-control study was performed on 34 patients and 68 healthy children who were matched in terms of inclusion and exclusion criteria. Children development screening test (ASQ), children development assessment test (Bayley), preschool Wechsler intelligence scale (WPPSI) and age and steps questionnaire of emotional social development (ASQ-SE) were completed by trained questioners. Data were analyzed using STATA software.
Results:
The results indicated that there was no significant difference between the mean of verbal (P = 0.77), non-verbal (P = 0.81) and general (P = 0.66) IQ in permanent and transient patients and healthy individuals. Also, there was no significant difference between the mean of different ranges of ASQ test (including communication, delicate and large movements, problem solving and social) at 12 months and 42 months (P < 0.05). According to Bayley test, there was no significant difference between the cases (permanent and transient) and controls in the cognitive (P = 0.42) and expressive (P = 0.38) categories. The difference was significant in the perceptual (P = 0.011), large (P = 0.03) and delicate (P = 0.04) movements categories.
Conclusion:
This study emphasized on the high effectiveness of neonate hypothyroidism screening program, so that the difference between 3.5 years old children with and without this disease has decreased significantly. Early diagnosis of the patients, while creating beneficial effects for patients and increasing quality of life, cause reduction in the long-term costs of the health system.
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