Dalili Setila, Rezvani Seyed Mahmood, Dalili Hossein, Mohtasham Amiri Zahra, Mohammadi Hamid, Abrisham Kesh Sahar, Novin Mohammad Hassan, Medghalchi Abdolreza, Gholamnezhad Hajar
Pediatrics Growth Disorders Research Center, 17 Shahrivar Hospital, Faculty of Medicine, Guilan University of Medical Sciences, Guilan, Iran.
Health Center, Guilan University of Medical Sciences, Guilan, Iran.
Acta Med Iran. 2014;52(10):752-6.
One of the most preventable causes of mental and growth retardation is congenital hypothyroidism (CH). This study tries to investigate growth and mental outcome of patients with CH. Since November 2006 and November 2007 in Guilan province, north of Iran, all neonates who were diagnosed with CH, evaluated for etiology of CH by laboratory follow up, thyroid sonography or scan. Growth and development of patients with CH were compared with healthy children in same age, geographical area, social and economical classes in four years old. Demographic characteristics including height, weight, and head circumference at birth, follow up time (four years old) and IQ (Good enough test) were recorded in questionnaires. Among 28904 screened neonates, 37 patients with CH were diagnosed. Incidence of CH was 1:781 in live births, 20 (54%) in female neonates and 17 (46%) in male neonates. The incidences of permanent and transient hypothyroidism were 43.2% (16 cases) and 56. 8% (21 cases) respectively. The incidence of permanent and transient hypothyroidism were 16 (43.2%) and 21 (56, 8%), respectively. In permanent CH, 11 cases (%.68.2) had dyshormonogenesis and 5 cases (%.31.2) had thyroid dysgenesis. Significant statistical difference was only in family history of thyroid disease (34, 3% Positive family history in CH vs. 13.2% in control group, P-value 0.03). All other demographic characteristics and IQ had no statistical difference. Patients with CH diagnosed through neonatal screening and treated had normal growth as general population that indicates effective screening program and treatment in this area (3.2%).
智力和生长发育迟缓最可预防的病因之一是先天性甲状腺功能减退症(CH)。本研究旨在调查CH患者的生长发育及智力结局。2006年11月至2007年11月期间,在伊朗北部的吉兰省,所有被诊断为CH的新生儿,通过实验室随访、甲状腺超声或扫描评估CH的病因。将CH患者的生长发育情况与4岁时年龄、地理区域、社会和经济阶层相同的健康儿童进行比较。通过问卷记录人口统计学特征,包括出生时的身高、体重和头围、随访时间(4岁时)以及智商(采用足够好测试)。在28904例筛查的新生儿中,确诊37例CH患者。CH在活产中的发病率为1:781,女性新生儿20例(54%),男性新生儿17例(46%)。永久性和暂时性甲状腺功能减退症的发病率分别为43.2%(16例)和56.8%(21例)。永久性和暂时性甲状腺功能减退症的发病率分别为16例(43.2%)和21例(56.8%)。在永久性CH中,11例(68.2%)有激素合成障碍,5例(31.2%)有甲状腺发育异常。仅甲状腺疾病家族史存在显著统计学差异(CH患者中34.3%有阳性家族史,对照组为13.2%,P值0.03)。所有其他人口统计学特征和智商均无统计学差异。通过新生儿筛查确诊并接受治疗的CH患者生长发育与普通人群正常,表明该领域的筛查计划和治疗有效(3.2%)。