title: Neonatal screening for congenital hypothyroidism in the Netherlands: cognitive and motor outcome at 10 years of age.
abstract: BACKGROUND
  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 T(4) 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.
  
  
  METHODS
  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 T(4) concentration.
  
  
  METHODS
  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 T(4) supplementation from 28 to 20 d after birth did not result in improved cognitive or motor outcome in CH-T patients.
authors.affiliation: Department of Pediatric Endocrinology, Emma Children's Hospital Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands. m.j.kempers@amc.uva.nl
authors.forename: Marlies J E
authors.initials: MJ
authors.lastname: Kempers
authors.forename: Liesbeth
authors.initials: L
authors.lastname: van der Sluijs Veer
authors.forename: Ria W G
authors.initials: RW
authors.lastname: Nijhuis-van der Sanden
authors.forename: Caren I
authors.initials: CI
authors.lastname: Lanting
authors.forename: Libbe
authors.initials: L
authors.lastname: Kooistra
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Wiedijk
authors.forename: Bob F
authors.initials: BF
authors.lastname: Last
authors.forename: Jan J M
authors.initials: JJ
authors.lastname: de Vijlder
authors.forename: Martha A
authors.initials: MA
authors.lastname: Grootenhuis
authors.forename: Thomas
authors.initials: T
authors.lastname: Vulsma
mesh_terms: D002648:Child; D015331:Cohort Studies; D003409:Congenital Hypothyroidism / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007360:Intelligence; D008297:Male; D009048:Motor Skills; D015997:Neonatal Screening; D009426:Netherlands; D013974:Thyroxine / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D013974:Thyroxine