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Neonatal Screening for Congenital Hypothyroidism in The Netherlands: Cognitive and Motor Outcome at 10 Years of Age

Emma Children’s Hospital Academic Medical Center, University of Amsterdam, Departments of Pediatric Endocrinology (M.J.E.K., B.M.W., J.J.M.d.V., T.V.) and Pediatric Psychology (L.v.d.S.V., B.F.L., M.A.G.), 1100 DE Amsterdam, The Netherlands; Department of Pediatric Physical Therapy (R.W.G.N.-v.d.S.), Radboud University, Nijmegen Medical Center, 6525 GA Nijmegen, The Netherlands; Department of Prevention and Healthcare (C.I.L.), Netherlands Organization of Applied Scientific Research, Quality of Life, 2301 CE Leiden, The Netherlands; and Department of Paediatrics (L.K.), Behavioral Research Unit, Alberta Children’s Hospital, Calgary, Canada T2T 5C7

Address all correspondence and requests for reprints to: Marlies J. E. Kempers, Department of Pediatric Endocrinology, Emma Children’s Hospital Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands. E-mail: m.j.kempers{at}amc.uva.nl.

Context: Patients with thyroidal congenital hypothyroidism (CH-T) born in The Netherlands in 1981–1982 showed persistent intellectual and motor deficits during childhood and adulthood, despite initiation of T₄ supplementation at a median age of 28 d after birth.

Objective: The present study examined whether advancement of treatment initiation to 20 d had resulted in improved cognitive and motor outcome.

Design/Setting/Patients: In 82 Dutch CH-T patients, born in 1992 to 1993 and treated at a median age of 20 d (mean, 22 d; range, 2–73 d), cognitive and motor outcome was assessed (mean age, 10.5 yr; range, 9.6–11.4 yr). Severity of CH-T was classified according to pretreatment free T₄ concentration.

Main Outcome Measure: Cognitive and motor outcome of the 1992–1993 cohort in comparison to the 1981 to 1982 cohort was the main outcome measure.

Results: Patients with severe CH-T had lower full-scale (93.7), verbal (94.9), and performance (93.9) IQ scores than the normative population (P < 0.05), whereas IQ scores of patients with moderate and mild CH-T were comparable to those of the normative population. In all three severity subgroups, significant motor problems were observed, most pronounced in the severe CH-T group. No correlations were found between starting day of treatment and IQ or motor outcome.

Conclusions: Essentially, findings from the 1992–1993 cohort were similar to those of the 1981–1982 cohort. Apparently, advancing initiation of T₄ supplementation from 28 to 20 d after birth did not result in improved cognitive or motor outcome in CH-T patients.

This article has been cited by other articles:

				M Korada, M Kibirige, S Turner, J Day, H Johnstone, and T Cheetham The implementation of revised guidelines and the performance of a screening programme for congenital hypothyroidism J Med Screen, March 1, 2008; 15(1): 5 - 8. [Abstract] [Full Text] [PDF]

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