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Analysis of motor, cognitive and language performance of infants undergoing treatment for congenital hypothyroidism
Môyra A Romero1, Maura M F Goto2, Michelle P C d'Ouro3
1Universidade Metodista de Piracicaba (UNIMEP), Programa de Pós-graduação em Ciências do Movimento Humano, Piracicaba, SP, Brazil.
Insights
Infants with congenital hypothyroidism (CH) face higher risks of developmental delays, especially with higher thyroid-stimulating hormone (TSH) levels. Early detection and intervention are crucial for these infants.
Area of Science:
- Pediatrics
- Endocrinology
- Developmental Pediatrics
Background:
- Congenital hypothyroidism (CH) is a condition requiring early intervention to prevent developmental issues.
- Thyroid-stimulating hormone (TSH) levels can indicate the severity of CH.
- Developmental delays in infants with CH necessitate understanding risk factors.
Purpose of the Study:
- To investigate the association between treatment onset age and TSH levels with developmental delay risk in infants with CH.
- To identify infants with CH at greater risk for developmental delays.
Main Methods:
- A cross-sectional, observational, unmatched case-control study was conducted.
- Seventy-seven infants with CH were evaluated using the Bayley-III Screening Test.
- Infants were categorized by risk for developmental delay based on performance percentiles.
Main Results:
- Infants with CH showed higher risks in cognition, receptive language, and motor skills compared to controls.
- Higher TSH levels (indicating more severe CH) were significantly associated with poorer outcomes in cognition, receptive language, and fine/gross motor skills.
- Specific odds ratios (OR) demonstrated increased risk for cognitive and language impairments with elevated TSH.
Conclusions:
- Confirmatory TSH levels are valuable indicators for identifying infants with CH at higher risk of developmental delays.
- Close developmental monitoring and early intervention are essential for infants diagnosed with CH.
- Proactive management strategies can mitigate the impact of CH on cognitive and motor development.
Objective:
Investigate the association between the age of treatment onset and confirmatory TSH level (as an indicator of severity) with a greater risk of developmental delay in infants with congenital hypothyroidism (CH).
Method:
The authors conducted a cross-sectional, observational, unmatched case-control study at a Brazilian neonatal screening reference center. Seventy-seven infants with CH (mean age: 12 ± 6.4 months) were examined. The authors evaluated their performance using the Bayley-III Screening Test and categorized them as "LOWER RISK" (competent category) or "GREATER RISK" (combined at-risk + emergent categories) for developmental delay based on the 25th percentile cutoff.
Results:
Infants with CH are at a higher risk of non-competent performance in cognition, receptive language, fine motor skills, and gross motor skills when compared to infants without CH. This risk is more pronounced in infants with more severe indications of CH (TSH > 30 μUI/L in the confirmatory test) for cognition (OR = 5.64; p = 0.01), receptive language (OR = 14.68; p = 0.000), fine motor skills (OR = 8.25; p = 0.000), and gross motor skills (OR = 5.00; p = 0.011).
Conclusion:
The level of TSH in the confirmatory test can be a good indicator for identifying infants with CH who are at a higher risk of non-competent performance in cognition, receptive language, and motor skills. Monitoring development, early detection of delays, and intervention programs are particularly important for infants with CH.
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