Childhood IQ measurements in infants with transient congenital hypothyroidism*

Calaciura, Francesca; Mendorla, G.; Distefano, Marco; Castorina, Salvatore; Fario, Teresa; Motta, Rosa Maria; Sava, Lidia; Delange, François; Vigneri, Riccardo

doi:10.1111/j.1365-2265.1995.tb02620.x

Cited by 81 publications

(47 citation statements)

References 18 publications

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“…However, this approach allows the early diagnosis of fetal hypothyroidism and the provision of substitutive therapy in utero (25,26). Several recent studies have shown that intrauterine hypothyroidism is associated with decreased IQ values at 3-7 years even if a correct neonatal thyroid hormone replacement therapy is provided (27)(28)(29)(30)(31)(32).…”

Section: Discussionmentioning

confidence: 99%

Maternal compound W serial measurements for the management of fetal hypothyroidsm

Cortelazzi

Morpurgo

Zamperini

et al. 1999

European Journal of Endocrinology

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Objective: The diagnosis of fetal hypothyroidism is based at present on measurements of TSH and free thyroxine (FT4) in fetal blood samples obtained by cordocentesis. The measurement of maternal serum and urinary concentrations of compound W, immunologically similar to but chromatographically distinct from diiodothyronine sulfate (T2S), has been advocated as a new possible marker for fetal hypothyroidism. Design: In this paper, we measured serum compound W levels in 84 pregnant women, 20 with and 64 without thyroid disorders before and during specific treatment. Compound W was also assessed in fetal blood obtained by cordocentesis from 49 normal fetuses and 4 fetuses with suspected hypothyroidism due to transplacental passage of propylthiouracil (PTU). Compound W levels were measured by T2S RIA in maternal and fetal serum. To assess the possible usefulness of 3,5,3 0 -triiodothyroacetic acid (TRIAC) for therapy of fetal hypothyroidism we evaluated the transplacental passage of TRIAC by administering the drug to four pregnant women before therapeutic abortion. Results: In normal pregnancies, both maternal and fetal compound W levels increased progressively during gestation with a significant direct correlation (P < 0.001, in both mothers and fetuses). Moreover, a significant positive correlation was observed between fetal compound W and fetal FT4 values (P < 0.005), whereas no correlation was observed between maternal serum compound W and maternal FT4 in either euthyroid or hyperthyroid women, suggesting the fetal origin of compound W. The hypothyroid fetuses of PTU-treated mothers showed low compound W levels, and maternal compound W values were in the low normal range and did not show the typical increase during progression of gestation. A significant increase of maternal compound W was observed when the PTU dose was reduced. TRIAC was documented to cross the placental barrier and the treatment of a hyperthyroid pregnant woman on PTU caused the high fetal TSH levels and goiter to normalize. Conclusions: Serial measurements of 3,3 0 -T2S crossreactive materials (compound W and 3,3 0 -diiodothyroacetic acid sulfate) in maternal blood and the administration of TRIAC to the mother may represent a useful and safe alternative to invasive techniques for the diagnosis and therapy of fetal hypothyroidism.

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Section: Discussionmentioning

confidence: 99%

Maternal compound W serial measurements for the management of fetal hypothyroidsm

Cortelazzi

Morpurgo

Zamperini

et al. 1999

European Journal of Endocrinology

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“…To date, observations indicate a beneficial therapeutic effect of early treatment. [19][20][21] Studies on this early treatment in neonates are planned for the area serviced by the screening programme in Krakow. The assessment of the psychophysical status of the group at risk should resolve the issue of the validity of introducing rescreening in neonates with low and very low birth weight.…”

Section: Discussionmentioning

confidence: 99%

Screening for congenital hypothyroidism: the value of retesting after four weeks in neonates with low and very low birth weight

2005

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Objectives Thyroid-stimulating hormone (TSH), normally a reliable screening test for congenital hypothyroidism (CH), may fail to detect cases among infants who have low and very low birth weight. The purpose of this study was to identify neonates with false-negative screening results. Setting A province in Poland in which 3854 neonates had body weight p2500 g, between 1999 and 2001. Methods TSH levels in blood on filter paper were measured in all neonates between the third and sixth days after birth, but were repeated in low and very low birth weight infants after four weeks of age.Results The repeat test showed TSH levels X10 mIU/L in 19 of the 3854 low birth weight neonates. The final diagnosis in these neonates was permanent CH in two, transient CH in five, possible compensated CH in six and transient high TSH in six. Of the 19, 16 (84%) required iodine and/or thyroxine replacement therapy. Conclusions In neonates with low and very low birth weight, normal TSH levels measured between the third and sixth day of life do not exclude thyroid dysfunction, but a repeat TSH measurement after the fourth week of life identifies the false-negative results. In our data, the prevalence of primary and secondary hypothyroidism (both permanent and transient) was about 0.5%.

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“…[3] Elevated serum thyroid-stimulating hormone (TSH) may be due to congenital hypothyroidism or iodine deficiency. [4] Both conditions can result in mental retardation. [5] The World Health Organization (WHO), United Nations International Children's Emergency Fund (UNICEF), and International Council for Control of Iodine Deficiency Disorders (ICCIDD) have made a proposal for assessing iodine deficiency disorders (IDD).…”

Section: Introductionmentioning

confidence: 99%