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Updated: Aug 18, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Growth, development, and reassessment of hypothyroid infants diagnosed by screening
Insights
This study reassessed 36 neonates with congenital hypothyroidism at 1 year. Most maintained normal growth and development, with persistent hypothyroidism confirmed in 31 cases after treatment withdrawal.
Area of Science:
- Pediatrics
- Endocrinology
- Neonatal Care
Background:
- Congenital hypothyroidism (CH) requires lifelong management.
- Neonatal screening identifies CH, but long-term outcomes and treatment adjustments need further study.
Purpose of the Study:
- To evaluate the growth and neurodevelopmental outcomes of neonates with CH at one year of age.
- To assess the persistence of hypothyroidism after a trial of treatment withdrawal.
- To identify factors associated with treatment response and guide optimal L-thyroxine dosing.
Main Methods:
- Reassessment of 36 neonates diagnosed with CH via newborn screening at one year of age.
- Monitoring of growth parameters and neurodevelopmental scores.
- Thyroid stimulating hormone (TSH) and serum thyroxine (T4) levels were measured before and after L-thyroxine withdrawal in a subset of patients.
Main Results:
- Satisfactory growth and normal mental development were observed in most neonates.
- Persistent hypothyroidism was confirmed in 31 out of 32 cases after treatment withdrawal.
- Elevated TSH levels before withdrawal correlated with lower serum T4 and smaller L-thyroxine doses.
Conclusions:
- Congenital hypothyroidism often persists beyond infancy, necessitating continued monitoring.
- Regular monitoring of serum T4 and dose adjustment to the upper reference range are crucial for optimal L-thyroxine therapy in CH.
- Early identification and management of CH support favorable neurodevelopmental outcomes.
Abstract:
Thirty]six neonates in whom hypothyroidism was diagnosed after thyroid stimulating hormone screening were reassessed at 1 year. All had grown satisfactorily and the mental development scores were normal in all except two. Treatment was withdrawn in 32 and persistent hypothyroidism was confirmed in 31 cases. Thyroid stimulating hormone concentrations were raised in one-third of cases before the withdrawal of treatment and this was associated with generally lower concentrations of serum thyroxine (T4) and smaller doses of L-thyroxine than in those cases with normal concentrations of thyroid stimulating hormone. In treating congenital hypothyroidism, serum T4 concentrations should be monitored regularly and the dose of thyroxine adjusted to maintain serum T4 in the upper part of the reference range.
