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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurodevelopmental Follow-Up of Children Born to Mothers with Graves' Disease and Neonatal Hyperthyroidism
Francisca Grob1, Amy Brown2, Margaret Zacharin3
1Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Insights
Neonatal hyperthyroidism may cause subtle neurodevelopmental issues in children, influenced by socio-economic factors. Early detection and inclusive care are recommended for affected infants.
Area of Science:
- Pediatrics
- Endocrinology
- Neurodevelopmental Pediatrics
Background:
- Neonatal hyperthyroidism, often linked to maternal Graves' disease, poses potential neurodevelopmental risks.
- Excess fetal thyroid hormone exposure is associated with neurological conditions such as ADHD and epilepsy.
- The long-term neurodevelopmental impact of transient neonatal hyperthyroidism remains under-investigated.
Purpose of the Study:
- To investigate the neurodevelopmental outcomes in children with a history of neonatal hyperthyroidism.
- To compare executive functions, behavior, and social communication in affected children versus controls.
- To explore the influence of socio-demographic factors on these neurodevelopmental outcomes.
Main Methods:
- Retrospective study of 21 neonates with hyperthyroidism due to maternal Graves' disease.
- 10 children participated, completing questionnaires on executive functions (BRIEF), behavior (SDQ), and social communication (SCQ).
- Outcomes compared to community-recruited controls, with analysis of socio-demographic and clinical data.
Main Results:
- Participants showed significantly more social difficulties (SCQ scores) and behavioral issues (SDQ scores) compared to controls.
- Increased executive function challenges, including problem-solving and self-regulation deficits, were observed.
- Socio-demographic factors, such as family living situation and parental education, significantly influenced neurodevelopmental measures.
Conclusions:
- Neonatal hyperthyroidism may be associated with subtle neurodevelopmental variations.
- Socio-economic and family dynamics can potentially exacerbate these effects.
- Early detection, intervention, and inclusive care considering socio-economic factors are crucial for affected children.
Introduction:
Neonatal hyperthyroidism, often caused by maternal Graves' disease (GD), carries potential neurodevelopmental risks for children. Excessive thyroid hormones during fetal development are linked to neurological issues like ADHD and epilepsy. However, the impact of transient neonatal hyperthyroidism is not well understood.
Methods:
In a retrospective study at the Royal Children's Hospital in Melbourne, 21 neonates with hyperthyroidism from mothers with GD were examined. Of these, the parents of 10 children consented to participate; thus, questionnaires assessing executive functions, behavior, and social communication were completed. The outcomes were compared to those of control subjects recruited from the community using standardized tools (BRIEF, SDQ, SCQ). The results were analyzed against socio-demographic factors, maternal, and neonatal health.
Results:
No significant demographic or clinical differences were found between study participants (n = 10) and non-participants (n = 11). Participants, compared to controls, showed similar family demographics but a higher proportion of control parents had university-level education (p = 0.003). Patients displayed more social (SCQ scores: 12.1 ± 2.5 vs. 6 ± 1.07, p = 0.008) and behavioral difficulties (SDQ scores: 10.2 ± 2.17 vs. 6.14 ± 1.03, p = 0.03), with increased executive function challenges (BRIEF scores indicating problem-solving and self-regulation difficulties). Significant effects of family living situation and partner education level on neurodevelopmental measures were noted, underscoring the influence of socio-demographic factors.
Conclusions:
These findings suggest neonatal hyperthyroidism might lead to subtle neurodevelopmental variations, with socio-economic elements and family dynamics possibly intensifying these effects. While most children did not show severe impairments, early detection and intervention are recommended. The research emphasizes the necessity for inclusive care approaches that consider socio-economic factors for children affected by neonatal hyperthyroidism.
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