Comparison of developmental status between early treated congenital hypothyroid and healthy control children

Document Type : Original Article

Authors
Zahra Nafei 1 , 2
Bahar Hajiheidari 3
Mahtab Ordooei 1 , 2
Razieh Fallah 1
1 Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2 Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3 Department of pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
10.18502/wjpn.v4i2.8645
Abstract
Background: Early diagnosis and treatment of congenital hypothyroidism is the primary goal of neonates and children screening programs. This study aimed to evaluate and compare developmental skills in children with early-treated congenital hypothyroidism with healthy children using the Ages and Stages Questionnaires test (ASQ).
Methods: A total of 40 neonates with congenital hypothyroidism diagnosed during neonatal screening (thyroid stimulating hormone (TSH) > 10 mu/l) who were treated with Levothyroxine (10-15µ/kg) promptly within the first month of birth (after treatment, TSH < 4 mu/l) were evaluated for developmental skills using the ASQ test at 4, 8, and 12 months of age. The control group consisted of 40 healthy children matched with the case group in terms of age, sex, and socio-economic status. Chi-square and Fisher exact test were used with SPSS statistical software version 21 for analyzing the results.
Results: The overall mean ASQ score in case group was 262.7 ± 9.07, and in control group was 261.2 ± 8.49, which indicates no significant difference (P > 0.05). The ASQ test score increased significantly by age (P < 0.05). The girls' mean score of the ASQ test was significantly higher than boys in the case group (P < 0.05). Moreover, no significant difference was observed between the mean ASQ test score and the delivery type (P < 0.05).
Conclusion: This study showed that the developmental skills in children under-treatment of congenital hypothyroidism were at the standard level, indicating the effectiveness of early treatment to avoid developmental disorders.
Keywords
Hypothyroidism
Children
Developmental disorder
Ages and Stages Questionnaires
  1. Delavari A, Yarahmadi S, Mahdavi Hazaveh A, Nouroozi Nejad A, Dini M. Cost-benefit analysis of the neonatal screening program implementation for congenital hypothyroidism in I.R. Iran. Int J Endocrinol Metab 2006; 4(2): 84-7.
  2. Joseph R. Neuro-developmental deficits in early-treated congenital hypothyroidism. Ann Acad Med Singap 2008; 37(12 Suppl): 42-3.
  3. Karamizadeh Z, Amirhakimi GH. Incidence of congenital hypothyroidism in Fars Province, Iran. Iran J Med Sci 1992; 17(2): 78-80. [In Persian].
  4. Ogilvy-Stuart AL. Neonatal thyroid disorders. Arch Dis Child Fetal Neonatal Ed 2002; 87(3): F165-71.
  5. Rastogi MV, LaFranchi SH. Congenital hypothyroidism. Orphanet J Rare Dis 2010; 5: 17.
  6. Salim FA, Varma SK. Congenital hypothyroidism and the importance of universal newborn screening. Indian J Pediatr 2014; 81(1): 53-7.
  7. Selva KA, Harper A, Downs A, Blasco PA, Lafranchi SH. Neurodevelopmental outcomes in congenital hypothyroidism: comparison of initial T4 dose and time to reach target T4 and TSH. J Pediatr 2005; 147(6): 775-80.
  8. Simoneau-Roy J, Marti S, Deal C, Huot C, Robaey P, Vliet GV. Cognition and behavior at school entry in children with congenital hypothyroidism treated early with high-dose levothyroxine. J Pediatr 2004; 144(6): 747-52.
  9. Song SI, Daneman D, Rovet J. The influence of etiology and treatment factors on intellectual outcome in congenital hypothyroidism. J Dev Behav Pediatr 2001; 22(6): 376-84.
  10. Wheeler SM, Willoughby KA, McAndrews MP, Rovet JF. Hippocampal size and memory functioning in children and adolescents with congenital hypothyroidism. J Clin Endocrinol Metab 2011; 96(9): E1427-34.
  11. Frezzato RC, Santos DC, Goto MM, Ouro MP, Santos CT, Dutra V, et al. Fine motor skills and expressive language: a study with children with congenital hypothyoidism. Codas 2017; 29(1): e20160064.
  12. Babiker AM, Jurayyan NA, Mohamed SH, Abdullah MA. Overview of diagnosis, management and outcome of congenital hypothyroidism: a call for a national screening programme in Sudan. Sudan J Paediatr 2012; 12(2): 7-16.
  13. Dimitropoulos A, Molinari L, Etter K, Torresani T, Lang-Muritano M, Jenni OG, et al. Children with congenital hypothyroidism: long-term intellectual outcome after early high-dose treatment. Pediatr Res 2009; 65(2): 242-8.
  14. Soliman H, Abdel Hady AF, Abdel Hamid A, Mahmoud H. Language profile in congenital hypothyroid children receiving replacement Folia Phoniatr Logop 2016; 68(2): 67-72.
  15. Mozafari Kermani R, Ahmadi A, Sedighi J, Tavoussi M, Haeri Mehrizi A, Rostami R, et al. Evaluation of the incidence of neurodevelopmental disorders in children aged 1 to 3 years with congenital hypothyroidism treated with levothyroxine. Payesh 2018; 17(4): 399-407. [In Persian].
  16. Alvarez M, Carvajal F, Renón A, Pérez C, Olivares A, Rodríguez G, et al. Differential effect of fetal, neonatal and treatment variables on neurodevelopment in infants with congenital hypothyroidism. Horm Res 2004; 61(1): 17-20.
  17. Komur M, Ozen S, Okuyaz C, Makharoblıdze K, Erdogan S. Neurodevelopment evaluation in children with congenital hypothyroidism by Bayley-III. Brain Dev 2013; 35(5): 392-7.
  18. Pniewska-Siark B, Jeziorowska A, Bobeff I, Lewiński A. Analysis of physical and mental development of children with aplasia, hypoplasia and ectopy of the thyroid gland. Endocr Regul 2006; 40(1): 7-14.
  19. Trumpff C, de Schepper J, Vanderfaeillie J, Vercruysse N, Tafforeau J, van Oyen H, et al. No association between elevated thyroid-stimulating hormone at birth and parent-reported problem behavior at preschool age. Front Endocrinol (Lausanne) 2016; 7: 161.
  20. Buluş AD, Tiftik E. Evaluation of neurodevelopment of children with congenital hypothyroidism by the Denver Developmental Screening Test. J Pediatr Endocrinol Metab 2017; 30(10): 1061-6.
  21. Mikelsaar RV, Zordania R, Viikmaa M, Kudrjavtseva G. Neonatal screening for congenital hypothyroidism in Estonia. J Med Screen 1998; 5(1): 20-1.
  22. Al-Maghamsi MS, Al-Hawsawi ZM, Ghulam GN, Okasha AM. Screening for congenital hypothyroidism in North-West region of Saudi Arabia. Saudi Med J 2002; 23(12): 1518-21.
  23. Noori Shadkam M, Jafarizadeh M, Mirzaei M, Motlagh ME, Eslami Z, Afkhami Ardakani M, et al. Prevalence of congenital hypothyroidism and transient increased levels of TSH in Yazd Province. JSSU 2008; 16(3): 315. [In Persian].
  24. Razavi Z, Dalili S, Sabzehei MK, Yousefi A, Nouri S, Abedi M,et al. Developmental screening of children with congenital hypothyroidism using ages and stages questionnaires test. Iran J Child Neurol 2019; 13(2): 145-54.
  25. Molkenboer JF, Roumen FJ, Smits LJ, Nijhuis JG. Birth weight, and neurodevelopmental outcome of children at 2 years of age after planned vaginal delivery for breech presentation at term. Am J Obstet Gynecol 2006; 194(3): 624-9.

 

 

Journal of Integrated Maternal and Pediatric Care
Volume 4, Issue 2
December 2021
Pages 76-81

  • Receive Date 29 January 2022