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Evaluation of cognitive and motor development in toddlers with congenital hypothyroidism diagnosed by neonatal screening.
MedLine Citation:
PMID:  23027136     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: : The Dutch neonatal congenital hypothyroidism (CH) screening procedure and treatment modality has been adapted several times since its national institution in 1981. These changes enabled us to investigate whether earlier treatment has resulted in improved cognitive and motor outcomes. The present study examined whether the advancement of treatment modality has resulted in improved cognitive and motor outcomes.
METHODS: : In 95 toddlers with thyroidal CH (CH-T), born in 2002 through 2004 and treated at a median age of 9 days, cognitive and motor outcomes were assessed with the Bayley Scales of Infant Development-II-NL at 1 and 2 years of age. This outcome was also analyzed in relation to treatment variables.
RESULTS: : The mean mental developmental index (MDI) scores of the severe (initial free thyroxine [FT4] ≤0.4 ng/dL (≤5 pmol/L), moderate (0.4 < initial FT4 ≤ 0.8 ng/dL (5.0 < initial FT4 ≤ 10.0 pmol/L), and mild (initial FT4 > 0.8 ng/dL (>10.0 pmol/l) CH-T groups at 1 year and the moderate and mild CH-T groups at 2 years were similar to the population mean. The mean MDI scores of the total CH-T group and severe CH-T group at 2 years were significantly lower than the population mean (p < .0001). In all 3 severity subgroups, significant lower psychomotor developmental index scores (p < .0001) were observed. No correlations were found between starting day of treatment and developmental outcome. Initial T4 concentration and initial T4 dose were weak predictors for developmental outcome.
CONCLUSION: : Essentially, comparable with our earlier findings, children with CH, especially those with severe CH, are still at risk for motor and cognitive problems, which are probably due to the consequence of the prenatal hypothyroid state or the thyroid hormone deficiency in early life.
Liesbeth van der Sluijs Veer; Marlies J E Kempers; Brenda M Wiedijk; Bob F Last; Martha A Grootenhuis; Tom Vulsma
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of developmental and behavioral pediatrics : JDBP     Volume:  33     ISSN:  1536-7312     ISO Abbreviation:  J Dev Behav Pediatr     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006933     Medline TA:  J Dev Behav Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  633-40     Citation Subset:  IM    
*Psychosocial Department, Emma Children's Hospital AMC, University of Amsterdam, Amsterdam, the Netherlands †Department of Pediatric Endocrinology, Amsterdam, the Netherlands ‡Department of Clinical Genetics, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands §Department of Developmental Psychology, Vu University, Amsterdam, the Netherlands.
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