Cognitive outcome of 458 children over 25 years of neonatal screening for congenital hypothyroidism

• Main Authors: Julita Maria Pelaez (Author), Juliana Cristina Romero Rojas-Ramos (Author), Mouseline Torquato Domingos (Author), Marcella Rabassi de Lima (Author), Gabriela de Carvalho Kraemer (Author), Adriane de Andre Cardoso-Demartini (Author), Rosana Marques Pereira (Author), Luiz de Lacerda (Author), Suzana Nesi-França (Author)
• Format: Book
• Published: Elsevier, 2023-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 0021-7557; 10.1016/j.jped.2023.03.003
• Keywords: Congenital hypothyroidism; Wechsler scales; Psychometrics; Neonatal screening; Maternal education level; Pediatrics; RJ1-570
• Source: Jornal de Pediatria, Vol 99, Iss 5, Pp 478-484 (2023)

Objectives: To describe the neurocognitive profile of 458 children with congenital hypothyroidism detected by neonatal screening, followed under the same treatment protocol over 25 years. To correlate estimated full-scale IQ (FSIQ) scores with age at the start of treatment, disease severity, and maternal education. Methods: Observational, analytical, retrospective, and longitudinal cohort study, that evaluated children detected between 1991 and 2014, who underwent at least one psychometric assessment (WPPSI- R and/or WISC-III). Estimated FSIQ scores are described and correlated with prognosis determinants. Results: Median T4 at diagnosis was 2.8 μg/dL (0.0-16.5), the median age at the start of treatment was 18.5 days (3-309). Maternal education (n = 445): 2.7% of illiteracy, 59.8% with basic education. Estimated FSIQ scores were 88.0 (±11.8) in WPPSI-R (age 5.6 ± 0.5 years) and 84.1 (±13.0) in WISC-III (age 9.1 ± 1.4 years). The intellectual deficit was identified in 11.6%. Correlation between age at the start of treatment and estimated FSIQ was found only in the WPPSI-R test (p = 0.02). Initial T4 and maternal education significantly correlated with estimated FSIQ scores in both tests, with the latter being the most important determining factor. Conclusions: In this large cohort of mainly low socioeconomic status children, most children achieved normal cognitive levels; however, a significant percentage presented with below-average estimated FSIQ scores and intellectual deficits. Maternal education was the main determining factor in cognitive level followed by hypothyroidism severity.