Developmental screening of children with congenital hypothyroidism using Ages & Stages Questionnaires test.
Iranian Journal of Child Neurology,
Vol. 13 No. 2 (2019),
4 March 2019
,
Page 145-154
https://doi.org/10.22037/ijcn.v13i2.18475
Abstract
Abstract:
Objectives: Congenital hypothyroidism (CH) is one of the most common causes of mental retardation in children. This study investigated the developmental status of children with CH screened by Ages & Stages Questionnaires (ASQ) measurement scores.
Materials & Methods: In this retrospective study, neurodevelopmental status of 78 children diagnosed with CH who being followed up at the outpatient Pediatric Endocrinology Clinic of Besat Hospital, Hamadan, Iran, was evaluated by ASQ method. Data on age, sex, birth body weight, height and head circumference, residency location, parental education level, primary venous TSH and T4 level, diagnosis age, treatment start age and initial levothyroxine dosage were extracted from medical records .Data analyzed using statistical software SPSS v16. P-value less than 0.05 was considered statistically significant.
Results: Of the 78 patients (34=43.6% female), 32 patients (41%) had developmental disorder. 56 cases (71.8%) were living in urban areas. In terms of type of developmental impairment, global delay: 13 patients (40.6%), problem solving: 11 patients (34.3%), communication: 5 patients (15.6%), fine motor: 2 patients (6.2%) and personal-social: 1 patient (3.1%) were detected. The average of diagnosis and treatment age was 25.65 days in patients with developmental impairment and 17.99 days in those without delay. ASQ results had significant statistical correlation with initial dose of levothyroxine (p=0.017), hypothyroidism diagnosis age (p=0.002) and age of treatment initiation (p=0.018).
Conclusions: Early diagnosis and treatment along with initial L-thyroxin dose were most important factor of ASQ scores of children with CH. Higher amounts of the LT4 is required at onset.
- Congenital Hypothyroidism
- Levothyroxine
- Permanent Hypothyroidism
- Transient Hypothyroidism
- ASQ test
How to Cite
References
References:
Razavi Z, Yavarikia A, and TorabianS. Congenital Anomalies in Infant with Congenital Hypothyroidism. Oman Med J. 2012 September; 27(5): 364–367; doi: 10.5001/omj.2012.92
Foley T, Kaplowitz PB, Kaye CI, Sundararajan S, Varma SK. American Academy of Pediatrics, Rose SR, Section on Endocrinology and Committee on Genetics, American Thyroid Association, Brown RS, Public Health Committee, Lawson Wilkins Pediatric Endocrine Society, Pediatrics. 2006 Jun; 117(6):2290-303.
Jain V, Agarwal R, Deorari AK, Paul VK. Congenital hypothyroidism. The Indian Journal of Pediatrics. 2008;75(4):363-7; doi: 10.1007/s12098-008-0040-7.
Moreno JC, VisserTJ. New phenotypes in thyroid dyshormonogenesis: hypothyroidism due to DUOX2 mutations. Endocr Dev. 2007; 10:99-117.
Maruo Y, Takahashi H, Soeda I, Nishikura N, Matsui K, Ota Y, et al .Transient congenital hypothyroidism caused by biallelic mutations of the dual oxidase 2 gene in Japanese patients detected by a neonatal screening program. J ClinEndocrinolMetab. 2008 Nov; 93(11):4261-7. doi: 10.1210/jc.2008-0856.
Satoh M, Aso K, Ogikubo S, Yoshizawa-Ogasawara A, SajiT. Hypothyroidism caused by the combination of two heterozygous mutations: one in the TSH receptor gene the other in the DUOX2 gene. J PediatrEndocrinolMetab. 2015 May 1; 28(5-6):657-61. doi: 10.1515/jpem-2014-0078
Razavi z, Mohammadi L. Permanent and Transient Congenital Hypothyroidism in Hamadan West Province of Iran. International Journal of Endocrinology and Metabolism. 14(4): e38256 , DOI: 10.5812/ijem.38256
Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, et al. CDC growth charts: United States. Advance data. 2000; (314):1-27.
Squires J, Bricker D, Potter L. Ages and Stages Questionnaires source. Assessing children's well-being: a handbook of measures. 2003; 22:76
Hornman J, Kerstjens JM, de Winter AF, Bos AF, Reijneveld SA. Validity and internal consistency of the Ages and Stages Questionnaire 60-month version and the effect of three scoring methods. Early Hum Dev. 2013 Dec;89(12):1011-5. doi: 10.1016/j.earlhumdev.2013.08.016. Epub 2013 Sep 14.
Santana CM, Filgueiras A, Landeira-Fernandez J. Ages & Stages Questionnaire–Brazil–2011 Adjustments on an Early Childhood Development Screening Measure. Global Pediatric Health. 2015; 2: 2333794X15610038. doi: 10.1177/2333794X15610038. eCollection 2015.
Rovet JF1. Congenital hypothyroidism: an analysis of persisting deficits and associated factors Child Neuropsychol. 2002 Sep; 8(3):150-62.
Büyükgebiz A. Congenital hypothyroidism clinical aspects and late consequences. Pediatr Endocrinol Rev. 2003; 1(Suppl 2):185–90.
Huo K, Zhang Z, Zhao D, Li H, Wang J, Wang X, et al. Risk factors for neurodevelopmental deficits in congenital hypothyroidism after early substitution treatment. Endocr J. 2011; 58:355–61.
Grüters A1, Jenner A, Krude H .Long-term consequences of congenital hypothyroidism in the era of screening programs. Best Pract Res Clin Endocrinol Metab. 2002 Jun; 16(2):369-82
Bhavani N .Transient congenital hypothyroidism. Indian J Endocrinol Metab. 2011 Jul; 15(Suppl2): S117–S120. doi: 10.4103/2230-8210.83345.
LaFranchi SH1, Austin J. How should we be treating children with congenital hypothyroidism? J Pediatr Endocrinol Metab. 2007 May; 20(5):559-78.
Rovet JF, Ehrlich RM, Sorbara DL. Neurodevelopment in infants and preschool children with congenital hypothyroidism: etiological and treatment factors affecting outcome. 1992; J Pediatr Psychol 17:187–213
Simons WF, Fuggle PW, Grant DB, Smith I. Educational progress, behavior, and motor skills at 10 years in early treated congenital hypothyroidism. 1997; Arch Dis Child 77:219–222. 20. Hauri-Hohl A, Dusoczky N, Dimitropoulos A, Leuchter RH, Molinari L, Caflisch J, et al. Impaired neuromotor outcome in school-age children with congenital hypothyroidism receiving early high-dose substitution treatment. Pediatr Res. 2011; 70:614–8. doi: 10.1203/PDR.0b013e3182321128.
Kik E1, Noczyńska A .Evaluation of mental development of children with congenital hypothyroidism detected in screening test--personal observations .Pediatr Endocrinol Diabetes Metab. 2010; 16(2):100-8
Tillotson SL, Fuggle PW, Smith I, Ades AE, Grant DB. Relation between biochemical severity and intelligence in early treated congenital hypothyroidism: a threshold effect. BmJ.
; 309(6952):440-444
Romero JB, Palacios GC, Gómez N, Silva A, Fabela JH. Intelligence quotient related with congenital hypothyroidism etiology. Rev Med Inst Mex Seguro Soc. 92011; 4:179–83. [Article in Spanish]
Oerbeck B, Sundet K, Kase BF, Heyerdahl S. Congenital hypothyroidism: influence of disease severity and L-thyroxin treatment on intellectual, motor, and school-associated outcomes in young adults. Pediatrics. 2003; 112(4):923-30.
Rovet J, Daneman D. Congenital hypothyroidism: a review of current diagnostic and treatment practices in relation to neuropsychologic outcome. Paediatr Drugs. 2003; 5(3):141-9
Arenz S, Nennstiel-Ratzel U, Wildner M, Dörr HG, von Kries R. Intellectual outcome, motor skills and BMI of children with congenital hypothyroidism: A population-based study. Acta Paediatr. 2008; 97:447–50. doi: 10.1111/j.1651-2227.2008.00702.x. Epub 2008 Mar 7.
Trumpff C, De Schepper J, Vanderfaeillie J, Vercruysse N, Van Oyen H, Moreno-Reyes R, et al. Neonatal thyroid-stimulating hormone concentration and psychomotor development at preschool age. Arch Dis Child. 2016 Dec; 101(12):1100-1106. doi: 10.1136/archdischild-2015-310006.
Najmi SB, Hashemipour M, Maracy MR, Hovsepian S, Ghasemi M. Intelligence quotient in children with congenital hypothyroidism: The effect of diagnostic and treatment variables..
J Res Med Sci. 2013 May; 18(5):395-9.
Calaciura F, Mendorla G, Distefano M, Castorina S, Fazio T, Motta RM, et al. Childhood IQ measurements in infants with transient congenital hypothyroidism. Clin Endocrinol (Oxf). 1995; 43: 473–7.
Azizi F, Afkhami M, Sarshar A, Nafarabadi M. Effects of transient neonatal hyperthyrotropinemia on intellectual quotient and psychomotor performance. International journal for vitamin and nutrition research. 2001; 71(1):70-3.
Dalili S, Rezvani SM, Dalili H, Amiri ZM, Mohammadi H, Kesh SA, et al. Congenital hypothyroidism: etiology and growth-development outcome. Acta Medica Iranica. 2014; 52(10):752)-6
Kempers MJ, van der Sluijs Veer L, Nijhuis-van der Sanden RW, Lanting CI, Kooistra L, Wiedijk BM, et al. Neonatal screening for congenital hypothyroidism in the Netherlands: Cognitive and motor outcome at 10 years of age. J Clin Endocrinol Metab. 2007; 92:919–24
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