[Evaluation of mental development of children with congenital hypothyroidism detected in screening test--personal observations].
BACKGROUND
Thyroid hormones are crucial for a proper development of the central nervous system (CNS), skeleton and tooth buds. They are important from the early stages of fetal development. The aim of the study was to evaluate the mental development of children with congenital hypothyroidism detected in screening and to determine the effect of TSH, level of thyroid hormones during observation, perinatal factors as well as parental and environmental factors on the children's IQ.


METHODS
44 children (28 girls and 16 boys) aged 3.5-18 years (mean age 7.3+/- 3.5) were enrolled in the study. The subjects' mental development was analyzed. General intelligence quotient was measured on verbal and non-verbal scale and chosen parameters of mental development were measured. The evaluation of mental development was performed in two age groups: group A - 20 patients in the age range 3.5-5.9 years (mean age 5.3+/-0.8) tested using the Columbus method, and group B - 24 patients in the age range 6-18 years (mean age 10.3+/-2.2) tested on the Wechsler Scale.


RESULTS
The intelligence quotient (IQ) in both groups was within the average IQ range on Wechsler scale. Mean IQ values on verbal and non-verbal scale were comparable and within the average IQ range on Wechsler scale. The level of intelligence in group A correlated, on the brink of statistical significance (IS), with the education level of the parents (r=0.32; p=0.0934), while in the group B - IS correlated with birth weight (r=0.62; p=0.00247), it correlated on the brink of statistical significance with the education level of parents (r=0.4; p=0.0532) and mother's age (r=0.41; p=0.0514). The level of intelligence on verbal scale in group B, statistically significant, positively correlated with the body mass at birth (r=0.62; p=0.00147) and negatively with the mean value of TSH in 2-year follow-up period (r=-0.47; p=0.0381). The level of general intelligence and on verbal and non-verbal scale did not correlate with the time of commencement of therapy with LT4, place of residence or TSH value in the screening test.


CONCLUSIONS
1. Mental development of the studied children with CH was within normal range. 2. Out of all measured parameters determining mental development, tasks in mathematics, analysis and synthesis, visual concentration and concentration on the hearing level had worst results. 3. The level of TSH in the screening test had no effect on the mental development of children with CH. 4. Out of all environmental factors, parental education influenced the mental development of the studied children.
Kik
Eugenia
E
Klinika Endokrynologii i Diabetologii Wieku Rozwojowego Akademii Medycznej we Wrocławiu. kik@interia.pl
Noczyńska
Anna
A
D000293:Adolescent; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003409:Congenital Hypothyroidism / Q000150:complications* / Q000503:physiopathology*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007360:Intelligence / Q000145:classification*; D007361:Intelligence Tests; D008297:Male; D001523:Mental Disorders / Q000209:etiology; D010290:Parents