Neurodevelopmental outcome of congenital hypothyroidism in children between 1-5 years of age

Objective: To evaluate growth and development of children with congenital hypothyroidism (CHT) attend-ing Pediatric Endocrine OPD BIRDEM. Methodology: It is a cross sectional study which was conducted atPediatric outpatient department BIRDEM in a study period of 1 year (May 2008 to April 2009). A total num-ber of 80 children with CHT were included in the study. A data sheet was used for each subject containingall the information. History and thorough physical examination was carried out including anthropometry , and developmental assessment. Developmental assessment was done according to Denver developmentalscreening test using standard charts of developmental progress which is appropriate for child s age. TSH andFT4 were done by chemiluminescent method in multichannel auto analyzer . Other investigations includedbone x ray. Result: Total 80 children with congenital hypothyroidism between 1 to 5 years of age fulfillingthe inclusion criteria were studied. Majority of the study population (71.20%) were diagnosed outside BIR-DEM and 28.80% at BIRDEM. In the study population, 73.70% children were diagnosed within 1st threemonth of age and considered as early treated group, 26.20% diagnosed between three to nine month of ageand classified as late treated group. Majority (56.20%) of the study population were female, and 43.70%were male child. All children among study sample were from non goiter endemic zone. Only 3 (5.0%) chil-dren among early treated group had maternal history of thyroid disorder and H/O ingestion of anti thyroiddrugs and none among late treated group. 11(18.6%) dren had affected peer with similar disorder and there was no family history of endocrine disorder amongeither group of study sample. Among 59 early treated group of children only 5(8.4%) had coarse facies,2(3.3%) had ic, 2(3.3%) had delayed relaxation of ankle jerk and none had wide open fontanel. Out of 21 late treatedgroup of children, 12(57.1%) had coarse facies, 4(19%) had protruded tongue, 6(28.5%) had bradycardia,15(71.4%) children had dry rough skin, 16(76.1%) was hypotonic, 12(57.1%) had wide open fontanel anddelayed relaxation of ankle jerk. Among 59 early treated group of children 53(89.8%), 51(86.4%), 55(93%)had normal and 6(10.1%), 8(13.5%), 4(6.7%) had delayed gross motor, ly. Whereas among 14(66.6%) children had delay in gross motor , fine motor and cognition respectively . There was no visualimpairment among either group of children in study sample. Among 59 early treated group of children57(96.6%) had normal hearing and 47(82.6%) had normal speech. Whereas among 21 late treated group,hearing impairment was seen among 7(25.9%) and speech delay was noticed among 16(76.1%) children.Among early treated group only 2% children had delayed radiological bone age, whereas 6% childrenamong late treated group had delayed bone age. Conclusion: Congenital Hypothyroidism (CHT) is a seri-ous condition within first few weeks of life. It is concluded that, the later the treatment is started the poorer the outcomewill be.