Growth in children with congenital hypothyroidism detected by neonatal screening

doi:10.1016/S0022-3476(05)81641-5

The Journal of Pediatrics

Volume 116, Issue 1, January 1990, Pages 33-37

https://doi.org/10.1016/S0022-3476(05)81641-5 Get rights and content

A prospective analysis of physical growth in 56 children with congenital hypothyroidism compared the children's height, weight, and head circumference with population percentiles. Two measures of skeletal maturation and predictions of adult height were also compared with population standards. The mean percentiles for the children's height and head circumference were higher than population means. Although mean bone age scores were slightly higher, predictions of adult height did not differ significantly from midparental height (arithmetic mean of sum of parental heights) and population means. The duration of intrauterine hypothyroidism as measured by gestational bone age and the duration of postnatal hypothyroidism were inversely correlated with heights attained up to 9 years. This association suggests a possible long-term influence of early hypothyroidism on growth. In children with congenital hypothyroidism, maintenance of serum thyroxine levels in the upper half of the normal range results in normal growth patterns.

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Citation Excerpt :
Animal models have shown an association between maternal hypothyroidism and decreased brain size [31]. and Blazer et al. [32] have reported decreased head circumference in the children of hypothyroid mothers despite therapeutic supplementation. In contrast, large head size has been noted in several reports on infants with congenital hypothyroidism [33–35].
Perchlorate and similar anions compete with iodine for uptake into the thyroid by the sodium iodide symporter (NIS). This may restrict fetal growth via impaired thyroid hormone production.
We collected urine samples from 107 pregnant women and used linear regression to estimate differences in newborn size and gestational age associated with increases in perchlorate, thiocyanate, nitrate, and perchlorate equivalence concentrations (PEC; measure of total NIS inhibitor exposure).
NIS inhibitor concentrations were not associated with newborn weight, length, or gestational age. Each 2.62 ng/μg creatinine increase in perchlorate was associated with smaller head circumference (0.32 cm; 95% CI: −0.66, 0.01), but each 3.38 ng/μg increase in PEC was associated with larger head circumference (0.48 cm; −0.01, 0.97).
These anions may have effects on fetal development (e.g. neurocognitive) that are not reflected in gross measures. Future research should focus on other abnormalities in neonates exposed to NIS inhibitors.
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¹: Supported by a summer studentship grant (Mr. Aronson) from the Alumnae Association, Faculty of Medicine, University of Toronto.

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Original articleGrowth in children with congenital hypothyroidism detected by neonatal screening1

J Pediatr

J Pediatr

J Pediatr

Longitudinal assessment of children with congenital hypothyroidism detected by neonatal screening

Helv Paediatr Acta

Management of patients with congenital hypothyroidism

Br Med J

Head circumference, height, bone age and weight in 103 children with congenital hypothyroidism before and during thyroid hormone replacement

Helv Paediatr Acta

Management and outcome of children with congenital hypothyroidism detected on neonatal screening in South Australia

Med J Aust

A prospective investigation of children with congenital hypothyroidism identified by neonatal thyroid screening in Ontario

Can J Public Health

Original article
Growth in children with congenital hypothyroidism detected by neonatal screening1