Subtle Health Impairment and Socioeducational Attainment in Young Adult Patients with Congenital Hypothyroidism Diagnosed by Neonatal Screening: A Longitudinal Population-Based Cohort Study

Abstract

These findings highlight the need for careful monitoring of neurosensory functioning, weight, and long-term treatment adequacy throughout childhood and adulthood.

ENDOCRINOLOGY AND ADOLESCENCE: Congenital hypothyroidism: a clinical update of long-term outcome in young adults

“…However, such deficits appeared to be a less pronounced problem than hearing deficits in this population, with 55% of patients declaring visual problems, vs 48% of the general population (29). Visuospatial problems have also been suggested in some small series of patients (73,74).…”

“…One study investigated 12 older patients, at the age of 20 years, and suggested that auditory processing abnormalities persisted in these patients (59). In our nationwide study of 1202 young adult patients, we have recently shown that, at a median age of 23.4 years, a significantly larger proportion of the CH population than of the general population reported having hearing impairment (9.5 vs 2.5%) and that the risk of developing hearing impairment was more than three times higher in these patients than in the reference population (29,60). Hearing loss was mostly detected during childhood, at a median (23-75th percentile) age of 7.0 (3.4-19.0) years and 17% of the patients who declared hearing impairment at a median age of 23.4 years had required a hearing aid since a median age of 10 years.…”

“…We have recently shown that, at a median age of 23.4 years, a significantly larger proportion of the CH population than of the general population reported having other moderate to severe chronic diseases (5.7 vs 2.9%), and that patients with CH had a risk of developing a chronic disease twice that of the reference population (29,77). Half of the health problems reported were due to neurodevelopmental disorders, which were diagnosed at various ages, from the neonatal period to late adolescence.…”

“…Some children of school age have displayed minor deficits in psychomotricity, reaction time, memory and attention, and a delayed acquisition of language, but have progressed normally through the school system (20,21,22,23,24). By contrast, others have achieved lower levels of educational attainment during childhood and adulthood, mostly due to CH severity and treatment inadequacy (25,26,27,28,29). A subtle social disadvantage has been described in early adulthood (Table 1).…”

“…A subtle social disadvantage has been described in early adulthood (Table 1). However, this impairment has been found to have little impact from a public health standpoint, as most patients are well integrated into society, and are either still in education or employed at least part time (29).…”