[Evaluation of physical development of children with congenital hypothyroidism detected in the screening test--personal observations].

BACKGROUND

Congenital hypothyroidism (CH) is the most prevalent endocrinopathy resulting from thyroid hormones deficiency or lack of thyroid hormones (TH). Aim of the study is to evaluate the physical development of children with congenital hypothyroidism detected in screening tests, determine the effect of TSH level, thyroid hormones and perinatal, parental and environmental factors on the physical development of children.

METHODS

the study involved 79 children (47 girls, 32 boys) aged 3-18 years (mean age 7.3±3.5) with CH diagnosed in screening tests. Children's development was analysed in correlation with TSH value in the screening test, time of commencement of therapy with LT4, the initial dose of the LT4, mean TSH level in the first year of life, mean value of TSH and LT4 in the 2-year follow-up period, social origin, place of residence (village, city), parents': anthropometric parameters (BMI, height), age, level of education of the parents, which pregnancy it was, time of pregnancy. In children: body mass and length at birth, score on Apgar scale, additional chronic disease.

RESULTS

Too low body mass was usually observed in the 2-4 month of life - 11.1%, while in the following months, the number of children with body mass below the 3 centile became lower. In children diagnosed with too low body mass <18 month of life, in the subsequent months was observed a normalisation. No correlation was between the body mass and TSH in infancy, the place of residence and level of education of the parents in all examined groups. According to Palczewska, BMI >97 centile occurred more often in the group of children with CH in the age range of 11 months - 6.9 years than in the control group, whereas ≥7 years obesity did not occur. The number of children with insufficient body length increased in the age groups: 11-18 months - 7.4%; 1.6-3.9 years - 7.9 % and 4-6.9 years - 9.1%. Children ≥7 years with height <3 centile were not observed. The number of children with height >97 centile in three age groups did not go beyond 4%. The biggest number of children >97 centile was noted in the age group 1.6-3.9 years (7.9%). Mean height SDS in all age groups was within the norm (±1 SDS for healthy population).

CONCLUSIONS

1. Physical development of children in infancy was in normal range. 2. Mean SDS of body mass in children was in the range of 1sds for healthy population in each age quarter. 3. Mean SDS for BMI in all age groups was above zero. 4. Mean SDS for body length in all age groups was in the range ±1 SDS for healthy population. 5. Early initiation of therapy HT is a prerequisite for proper physical development of children with congenital hypothyroidism.