Neurodevelopmental profile of children with congenital hypothyroidism at 18–42 months of age: A case study from South India

Abstract

Objectives: Congenital hypothyroidism (CH) is the most common preventable cause of intellectual disability in the world. It has been shown in multiple studies that with early detection and treatment of CH normal cognitive function is attainable. The Bayley scales of infant development (BSID) have been used extensively to evaluate the developmental functioning and to assist in planning of treatment for infants with neurodevelopmental delays or disabilities. The aim of the study was to assess the neuromotor and neurocognitive development of children with CH and to correlate it with treatment initiation, duration, and normalization of thyroid stimulating hormone (TSH) post-replacement therapy. Material and Methods: This was a cross-sectional study, where children with diagnosed CH were selected from two tertiary care centers. The children aged between 18 and 42 months were called for the neurodevelopmental assessment using BSID-III. Results: A total of 53 children diagnosed with CH were enrolled. The mean age of children was 29.53 ± 8.7 months during the study. On evaluating the children, mean cognitive composite score (CS) was 102.83 ± 12.77. Mean language CS was 106.55 ± 19.47. Mean motor CS was 111.45 ± 16.4. We noticed that there was statistically significant negative correlation between time for normalization of TSH and BSID-III motor score (P = 0.03). There was no statistically significant correlation between day of initiation of treatment, initial TSH level, or dose of levothyroxine to the BSID-III (P > 0.05). Conclusion: Neurodevelopmental retardation has been detected in children with CH in whom time taken for normalization of TSH was longer. Babies diagnosed with CH should be under regular follow-up for evaluation of neuromotor developmental status by a multidisciplinary team.