Linear growth and neurodevelopmental outcome of children with congenital hypothyroidism detected by neonatal screening: A controlled study

Abstract

Introduction:Different growth and neuro-developmental outcomes have been associated with different doses of thyroxine given to infants with congenital hypothyroidism (CH).Materials and Methods:We studied the longitudinal growth pattern and assessed the neurodevelopment of 45 children with CH(25 girls, 20 boys) diagnosed through the national screening program in Qatar, for 6 years or more to examine the effects of initial T4 dosage (50 μg/day) with adjustment of T4 dose to maintain serum free T4 concentrations within the upper quartile of normal range and thyroid stimulating hormone < 4 mIU/mLThe birth size of newborns with CH diagnosed through the screening program before January 2003, was recorded and their growth in weight and stature was monitored every 3 months for at least 6 years of life. The IQ of children was assessed between 3 and 6 years of age using The Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III).Results:Birth weight, length, and head circumference of patients (3.21 ± 0.43 kg, 50.5 ± 3.21 cm and 34.1 ± 1.5 cm, respectively) did not differ than those for 10,560 normal newborns with normal thyroid function (3.19 ± 0.59 kg, 50.5 ± 2.2 cm and 34.2 ± 1.7 cm). During the first year CH children growth (25.8 ± 2.8 cm/year) was similar to those for normal infants (25.5 ± 0.75 cm/year). During the first 6 years, stature growth was normal in all children with CH versus Center for disease control and prevention (CDC) data. The mean height standard deviation score (HtSDS) of children with CH showed adjustment (± 0.5 SD) toward their mid-parental height SDS (MPHtSDS) only during the second year of life. The children's mean HtSDS was higher by an average of 0.4 SD between the 2nd and 7th year of life.Conclusion:These data proved that effective screening and treatment completely assures normal neurodevelopment and linear growth in patients with CH. The data showed that their HtSDS slightly exceeds their MPHtSDS during childhood.

Relationship between maternal thyroid-stimulating hormone (TSH) elevation during pregnancy and low birth weight: A longitudinal study of apparently healthy urban Japanese women at very low risk

“…Umbilical cord FT3 and FT4 concentrations vary widely among individuals; thus, the fetus may depend, at least in part, on maternal thyroid hormones in the third trimester [9]. This hypothesis is supported by the fact that birth weight does not differ between neonates with congenital hypothyroidism and healthy newborns [22], and serum T4 levels at birth are one-to two-thirds higher in neonates with congenital hypothyroidism than in healthy newborns [23]. Placental trophoblasts synthesize and secrete transthyretin (TTR), a thyroid hormone-binding protein [5].…”

Five-Year Follow Up of Physical Growth and Thyroid Hormone Levels in Infants With Congenital Hypothyroidism

“…Ashraf found no meaningful relationship between the weight of CH children and CDC healthy children. The weight growth patterns of both groups ran parallel to each other (20). Kik demonstrated that weight growth of all children with CH was within a normal range (21).…”

“…According to the study of Ashraf et al (2012), there was no considerable difference in OFC between the CH children and CDC healthy children, while children with CH had an appropriate OFC growth trend (20). Hashemipour et al reported that OFC of children with CH was smaller than that of healthy children until the age of three years (24), whereas in other studies it was shown to be larger in CH children (29).…”

“…All the patients had normal height in their first six years of life. They also concluded that screening along with treatment completely led to appropriate linear growth and mental development (20). Kik et al (2011) evaluated physical growth of children with CH, who were detected by screening in Poland.…”

Effect of thyroxine on initial catch-up growth in children with hypothyroidism

“…Most studies have assessed the growth of infants with congenital hypothyroidism detected by neonatal screening. [3][4][5] Few studies have been done to assess the catch-up growth in older children with hypothyroidism. Therefore, author undertook this study to assess the catch-up growth in children with primary hypothyroidism following treatment with thyroxine.…”