No Association Between Transient Hypothyroxinemia of Prematurity and Neurodevelopmental Outcome in Young Adulthood

Hollanders, Jonneke J.; Israëls, Joël; Pal, S.M. van der; Verkerk, P.H.; Rotteveel, Joost; Finken, Martijn J J

doi:10.1210/jc.2015-3078

Cited by 45 publications

(35 citation statements)

References 23 publications

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“…The difference between the IQs of cases and controls in PCH was 4 times more than TCH cases. In a previous study, it was demonstrated that there is no associations between Transient hypo-thyroxinemia of prematurity (THoP) and neuro-developmental outcome at age 19 years [15]. Our results are also consistent with the study of cognitive and motor outcome of early treatment of 82 Dutch CH patients [16], where patients with severe CH had lower verbal, performance, and full-scale IQs than the normative population, whereas IQ scores of patients with moderate and mild CH were comparable to those of the normative population [16].…”

Section: Discussionmentioning

confidence: 99%

Intelligence Quotient at the Age of Six years of Iranian Children with Congenital Hypothyroidism

et al. 2017

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Objective: To evaluate the success rate of the National newborn screening program in maintenance of intelligent quotient (IQ) of children with congenital hypothyroidism in Iran.Design: Retrospective cohort study. Methods:The IQ scores, in three subsets of verbal, non verbal (Performance) and full scale IQ, of 240 children diagnosed with Transient congenital hypothyroidism (TCH) and Permanent congenital hypothyroidism (PCH), from 5 provinces in 5 different geographical areas of Iran, were measured at the age of 6 years using revised Wechsler pre school and primary scale of intelligence and compared with 240 healthy children. We used independent sample t test and two-way ANOVA for data analysis.Results: Mean of verbal, performance, and full scale IQ scores were lower in the CH cases (permanent and transient) than the control group. Most of the IQ differences in two studied groups related to the PCH cases (P=0.005). Mean difference of IQs between children in the two groups in Yazd province (center of Iran) was higher than other provinces, and they also had significantly lower IQ than their control (healthy) children (P=0.001). No treated child had IQ<70. Conclusion:Although mean IQs of CH children was lower than their controls, IQ of all treated CH cases were close to the healthy children.Keywords: Management, Neonatal screening, Outcome. R R R R R E E E E E S S S S S E E E E E A A A A A R R R R R C C C C C H P H P H P H P H P AA A A A P P P P P E E E E E R R R R R C ongenital hypothyroidism (CH) is considered as one of the most important preventable causes of mental retardation in children [1]. The incidence of CH is different among neonates of various countries of the world and ranges from 1:2000 to 1:4000 [2-6], the incidence of CH in different areas of Iran is reported to vary from 1:400 to 1:1000 [7,8].In Iran, a National program of neonate screening was established from 2004-2005 [9]. In this program, thyroidstimulating hormone (TSH) is measured as a primary test, and positive tests are confirmed by serum thyroxine (T4). By the end of 2015, over 9 million neonates were screened and over 10 thousand children were diagnosed with CH and treated with levothyroxine (L-Thyroxine).The evaluation of this mass screening program, particularly from the view of maintaining the IQ of children with CH at the national level has been done [10,11], but there have been no systematic long-term follow-up studies for evaluation of intervention/treatment outcomes among hypothyroid children diagnosed by the nationwide newborn screening program in Iran. This study was done to assess the IQ of hypothyroid children diagnosed by national program of CH screening at age of 6 years, compared with healthy children in Iran. METHODSThis was a retrospective cohort study conducted in five provinces in different geographical areas of Iran. A total of 480 children in two study groups, including 240 children with CH and 240 healthy children were investigated in this comparative study. We first specified our samples based on mean difference sampl...

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Section: Discussionmentioning

confidence: 99%

Intelligence Quotient at the Age of Six years of Iranian Children with Congenital Hypothyroidism

et al. 2017

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“…In that case, supplementation of thyroid hormones during NTIS could be beneficial. On the other hand, a recent study in young adults did not confirm this association between transient hypothyroxinemia of prematurity and adverse neurodevelopmental outcomes [25]. Furthermore, neonatal T4 supplementation was not beneficial in premature infants [26].…”

Section: Discussionmentioning

confidence: 99%

Nationwide Evaluation of Congenital Hypothyroidism Screening during Neonatal Extracorporeal Membrane Oxygenation

et al. 2016

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Background: Thyroid hormone concentrations may deviate from normal values during critical illness. This condition is known as nonthyroidal illness syndrome (NTIS), and it can influence the results of screening for congenital hypothyroidism (CH) during neonatal extracorporeal membrane oxygenation (ECMO). Objectives: To determine the incidence of aberrant CH screening results in ECMO-treated neonates, to identify possible determinants, and to follow up patients with abnormal thyroid hormone concentrations. Methods: In this retrospective cohort study, we included 168 ECMO-treated neonates admitted from 2004 to 2014 and screened by protocol and divided them into the following 3 groups: group 1 (screened during ECMO, n = 107), group 2 (screened shortly before ECMO, n = 26), and group 3 (screened shortly after ECMO, n = 35). Results: CH screening results were aberrant in 67.3% (72/107) of the neonates screened during ECMO, in 73.1% (19/26) of the neonates screened before ECMO, and in 31.4% (11/35) of the neonates screened after ECMO (p < 0.001). Of the neonates with an aberrant screening result, all but 2 (i.e. 98%) had a low thyroxine concentration with a normal thyrotropin concentration at screening, as is seen in NTIS. None was diagnosed with CH. Mortality did not significantly differ between neonates with an aberrant screening result (32.4%) and neonates with a normal screening result (22.7%; p = 0.18). Screening before ECMO (OR 5.92; 95% CI 1.93-18.20), screening during ECMO (OR 4.49; 95% CI 1.98-10.19), and a higher Pediatric Logistic Organ Dysfunction-2 score (OR 1.31; 95% CI 1.04-1.66) were associated with an aberrant screening result. Conclusions: Aberrant CH screening results were found in most ECMO-treated neonates screened before or during ECMO, which is likely due to NTIS. Follow-up of thyroid hormone concentrations is best started after recovery from critical illness. Our results suggest that thyroxine therapy is not required during ECMO.

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“…However, these were observational studies that did not establish causality. A recent study from the Netherlands showed no association between THOP and neurodevelopmental outcomes in young adulthood (42). Efficacy of thyroid hormone therapy has also not been established.…”

Section: Thopmentioning

confidence: 98%

Transient hypothyroidism in the newborn: to treat or not to treat

Kanike¹,

Davis²,

Shekhawat³

2017

Transl. Pediatr

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No Association Between Transient Hypothyroxinemia of Prematurity and Neurodevelopmental Outcome in Young Adulthood

Abstract: No associations between THoP and neurodevelopmental outcome at age 19 years were found.

Cited by 45 publications

References 23 publications

Intelligence Quotient at the Age of Six years of Iranian Children with Congenital Hypothyroidism

Intelligence Quotient at the Age of Six years of Iranian Children with Congenital Hypothyroidism

Nationwide Evaluation of Congenital Hypothyroidism Screening during Neonatal Extracorporeal Membrane Oxygenation

Transient hypothyroidism in the newborn: to treat or not to treat

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