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Intellectual outcome in children with fetal hypothyroidism
Insights
Children with congenital hypothyroidism diagnosed later showed lower cognitive scores by age 2. Early detection and treatment are crucial for optimal neurodevelopment in infants with this condition.
Area of Science:
- Pediatric Endocrinology
- Developmental Pediatrics
- Neonatal Screening
Background:
- Congenital hypothyroidism (CH) is a common endocrine disorder in newborns.
- Newborn screening enables early detection of CH.
- Fetal hypothyroidism may impact neurodevelopmental outcomes.
Purpose of the Study:
- To investigate the neurodevelopmental outcomes of children with CH based on skeletal maturity at diagnosis.
- To determine if delayed skeletal maturity at diagnosis is associated with cognitive deficits.
Main Methods:
- Eighty children with CH detected by newborn screening were divided into two groups based on bone age at diagnosis: delayed (<36 weeks) and nondelayed (37 weeks to term).
- Intellectual and behavioral characteristics were assessed at ages 1, 2, 3, 4, and 5 years.
- Group comparisons were made for birth weight, hormone levels, family background, and neurodevelopmental scores.
Main Results:
- The delayed group (n=45) had significantly lower cognitive scores than the nondelayed group (n=35) from age 2 onwards.
- Perceptual-motor, visuospatial, and language areas were most affected in the delayed group.
- No significant differences were observed in birth weight, hormone levels, family background, behavior, or temperament between the groups.
Conclusions:
- Delayed skeletal maturity at diagnosis in CH is associated with poorer neurodevelopmental outcomes, particularly in cognitive domains.
- Early diagnosis and intervention are critical for optimizing cognitive development in infants with congenital hypothyroidism.
- Skeletal maturity at diagnosis can serve as an indicator for potential neurodevelopmental risks in CH patients.
Abstract:
Eighty children with congenital hypothyroidism detected by newborn screening were grouped for presence of fetal hypothyroidism using skeletal maturity at the time of diagnosis as the index. Forty-five children with bone age less than 36 weeks were assigned to the delayed group; 35 with bone age 37 weeks to term were assigned to the nondelayed group. Although most children with athyrosis were found in the delayed group, the groups did not differ in birth weight, hormone levels, or family background. Assessments of intellectual and behavioral characteristics at 1, 2, 3, 4, and 5 years of age revealed that, although children in the delayed group performed within the normal range, their scores were significantly lower than those of the nondelayed group from age 2 years on. Perceptual-motor, visuospatial, and language areas were most affected. There were no differences in behavior or temperamental characteristics.