Physical Development at School Entry in Children with Congenital Hypothyroidism Diagnosed by the National Program of Newborn Screening in Iran

Abstract

Background: The newborn screening program for diagnosing and treating children with congenital hypothyroidism (CH) in Iran was established in 2004. Objectives: This study aimed to evaluate the national program’s success in maintaining the physical development and anthropometric indexes of children with CH. Methods: This historical cohort study was carried out in five provinces located in five different geographical regions of Iran. The anthropometric indexes, including weight, height, and head circumference of 240 children diagnosed with transient congenital hypothyroidism (TCH) (n = 131) and permanent congenital hypothyroidism (PCH) (n = 109) were measured and compared with those of 240 healthy children aged six. Results: Mean ± standard deviation (SD) of weight, height, and head circumference of children with CH aged six were 20304.8 ± 4457.9 g, 115.6 ± 5.9 cm, and 50.8 ± 1.7 cm, respectively. Mean ± SD of height (116.7 ± 6.1 cm) and head circumference (51.1 ± 1.7 cm) in the control (healthy) group were significantly higher than those of the CH children group (P < 0.05). Mean ± SD weight in the control group (20741.2 ± 4337.3 g) was higher than that in the CH group (20304.8 ± 4457.9 g). However, the difference was not statistically significant (P = 0.3). No significant difference was observed between TCH and PCH children in the subgroup analysis (P > 0.05). Conclusions: Although the mean of anthropometric indexes in CH patients was slightly lower than that in healthy children aged six, the difference between the two groups was insignificant. The physical development of children with CH was evaluated as good. Our results suggested that the newborn screening program for identifying and treating children with CH in Iran may have improved the growth outcomes.

Current Status of Newborn Bloodspot Screening Worldwide 2024: A Comprehensive Review of Recent Activities (2020–2023)

“…Iran —Based on the success of pilot studies in three provinces, and basic support from IAEA, national NBS for CH in Iran was integrated into the national health system in 2005 and newborn coverage now exceeds 95% [ 20 , 1322 ]. To assess the quality and outcomes of the NBS program, at least three audits were completed in recent years, which showed normal growth and development at school age because of early diagnosis and treatment [ 1323 ], and good coverage but high recall and losses to follow-up. The latter program issues were addressed through the re-evaluation of cutoff levels and better surveillance of follow-up [ 1324 , 1325 ].…”

Evaluation of patients diagnosed with congenital hypothyroidism by newborn screening between 2011–2019 in Diyarbakir, Turkey

“…Numerous studies have shown that children with CH experience growth retardation. [ 29 ] However, it has been shown that early diagnosis and treatment can prevent growth retardation in patients with CH. [ 21 ] In a study conducted in 5 cities in Iran, consisting of school-age children at the age of 6 who were diagnosed with CH and healthy children, the weight was found to be similar between the 2 groups, while the height was shorter in children with CH.…”

“…[ 21 ] In a study conducted in 5 cities in Iran, consisting of school-age children at the age of 6 who were diagnosed with CH and healthy children, the weight was found to be similar between the 2 groups, while the height was shorter in children with CH. [ 29 ] In a study conducted in Turkey, it was found that 2.4% of school-age children between the ages of 6 to 10 had a weight-for-age below –2 SD and 5% had a length-for-age below –2 SD. [ 30 ]…”

“…[21] In a study conducted in 5 cities in Iran, consisting of school-age children at the age of 6 who were diagnosed with CH and healthy children, the weight was found to be similar between the 2 groups, while the height was shorter in children with CH. [29] In a study conducted in Turkey, it was found that 2.4% of school-age children between the ages of 6 to 10 had a weight-for-age below -2 SD and 5% had a length-for-age below -2 SD. [30] In our study, according to the most recent anthropometric assessment, 6.8% (n = 16) of the patients diagnosed with CH had a weight z-score below -2 SD, and 16.9% (n = 40) had a height z-score below -2 SD.…”