Neonatal screening for congenital hypothyroidism in the Netherlands: cognitive and motor outcome at 10 years of age.
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.
Kempers
Marlies J E
MJ
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
van der Sluijs Veer
Liesbeth
L
Nijhuis-van der Sanden
Ria W G
RW
Lanting
Caren I
CI
Kooistra
Libbe
L
Wiedijk
Brenda M
BM
Last
Bob F
BF
de Vijlder
Jan J M
JJ
Grootenhuis
Martha A
MA
Vulsma
Thomas
T
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
D013974:Thyroxine