Ref Number = PITIKA-ASPR0062
Adwina Nurlita K, Carrina Dewanti, Nur Rochmah, Muhammad Faizi, Ahmad Suryawan
OBJECTIVE: Thyroid hormones are essential for growth and brain development in childhood. Although hypothyroidism is the most common reason for mental retardation, normal neurological development can be achieved through early and effective treatment. The aim of the study is to evaluate development of children with congenital hypothyroidism (CHT).
METHOD: A cross sectional study conducted at Pediatric Endocrinology outpatient clinic from March to May 2019. A total number of 40 children with CHT were included in the study. Developmental outcome was examined with the Denver II; evaluated personal-social, fine motor, language and gross motor aspects; defined as normal if there is no delay or at the maximum one caution, or suspect if found two or more cautions and/or one delay. Associated factors were initial L-T4 dose, age at treatment, and length of treatment. Statistical analysis performed using Spearman correlation test, with P<0.05 considered significant.
RESULTS: There were 6/40 children with peripheral hypothyroidism, and 34/40 with central hypothyroidism, with median age 2.95 (2-9) years. Most patients (35/40) came with initial complain gross motor delayed, followed with neurological impairments (17/40), congenital heart disease (10/40), and proven CMV infection (4/40). Length of treatment doesn’t correlate significantly with each Denver II aspects: personal social (r=0.059; P 0.708), fine motor (r=0.157; P 0.314), language (r=0.086; P 0.583), and gross motor (r=0.166; P 0.287). The gross motor development correlated positively with initial L-T4 dose >10mcg (r=0.34; P<0.05), with median initial L-T4 dose was 50 (25-100) mcg; and correlated negatively with age at treatment (r=-0.42; P<0.01); with median age at treatment 12 (1-80) months; while language, fine motor, and personal social aspect was not correlated with initial L-T4 dose neither age of treatment, with P>0.05.
CONCLUSION: CHT mostly affects gross motor development. The higher initial L-T4 dose and earlier age at treatment may lead to better developmental outcome.
Keywords: Hypothyroidism; levothyroxine; neurodevelopmental outcome
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