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Intellectual development at 10 years in early treated congenital hypothyroidism

W F Simons1, P W Fuggle, D B Grant

  • 1MRC Register of Children with Congenital Hypothyroidism, Institute of Child Health, London.

Archives of Disease in Childhood
|September 1, 1994
PubMed

Insights

Children with severe congenital hypothyroidism show a persistent IQ deficit at age 10. This cognitive difference, detected early, remains evident years later, impacting intellectual development.

Area of Science:

  • Pediatric Endocrinology
  • Developmental Neuroscience
  • Child Psychology

Background:

  • Congenital hypothyroidism (CH) is a condition requiring early detection and treatment.
  • Neonatal screening allows for early identification of CH.
  • The long-term cognitive impact of CH, particularly severe forms, requires continued investigation.

Purpose of the Study:

  • To assess the long-term cognitive outcomes in children with CH at 10 years of age.
  • To determine if cognitive deficits observed in early childhood persist into later childhood.
  • To correlate IQ scores with the severity of CH based on pretreatment thyroxine levels.

Main Methods:

  • A cohort of 59 children diagnosed with CH via neonatal screening was assessed at age 10.
  • Cognitive function was evaluated using the Wechsler intelligence scale for children (WISC).
  • Participants were compared to 59 matched classroom controls; severity was based on pretreatment thyroxine levels.

Main Results:

  • Children with severe CH (pretreatment thyroxine ≤ 40 nmol/l) had a mean full-scale IQ of 104.7 (SD 15.1).
  • Less severely affected children (pretreatment thyroxine > 40 nmol/l) scored higher, with a mean IQ of 114.6 (SD 16.3).
  • Control groups scored similarly to less severely affected children (mean IQs 114.5 and 114.8).
  • IQ scores at 10 years strongly correlated with scores at 3 and 5 years in hypothyroid children.

Conclusions:

  • The cognitive deficit identified in early childhood for children with severe CH persists at age 10.
  • Early treatment and monitoring are crucial for optimizing cognitive outcomes in CH.
  • This study highlights the lasting impact of severe CH on intellectual development.

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