Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Endocrinology Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Neuropediatric Unit, Karolinska University Hospital, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
J Pediatr. 2024 Dec;275:114240. doi: 10.1016/j.jpeds.2024.114240. Epub 2024 Aug 14.
To study school achievement in grade 9 of compulsory school in children with congenital hypothyroidism (CH), both those detected by the national screening program and those with a normal screening result and thus diagnosed later.
Nationwide study of children in the Swedish Medical Birth Register (n = 1 547 927) from 1982 through 1997, linked to the neonatal screening CH cohort and the National School Register. Dried blood spot (DBS) samples are collected from all newborn infants, according to the neonatal screening program. Thyroid-stimulating hormone was used for CH screening. CH was defined as either having an abnormal screening result (DBS+) and treatment with levothyroxine (LT4+) or having a normal screening result but a CH diagnosis in the National Patient Register and treatment with LT4 (DBS-/ICD+/LT4+). Regression models were used to study school performance, which as measured as grade point sum and national test results. Sibling analysis also was performed to account for unmeasured familial factors.
There were 448 children who were DBS+/LT4+ and 475 children who were DBS-/ICD+/LT4+. Children with CH had lower grade point sum, adjusted β = - 6.34 (95% CI -11.7 to -1.01) and adjusted β = -10.3 (95% CI -15.5 to -5.20) for those with abnormal (DBS+/LT4+) and normal screening (DBS-/ICD+/LT4+) results, respectively. CH also was associated with lower result on the national tests, especially in mathematics. These associations remained in the sibling analyses.
Youth with CH had slightly lower school achievements compared with those without CH and compared with their siblings. CH children with a normal screening result, and thus diagnosed later, presented the lowest results on grade point sum and national tests.
研究先天性甲状腺功能减退症（CH）患儿在 9 年级时的学业成绩，包括通过国家筛查计划发现的患儿以及筛查结果正常但随后被诊断出的患儿。
在 1982 年至 1997 年期间，对瑞典医学出生登记处（n=1 547 927）的儿童进行了全国性研究，这些儿童与新生儿筛查 CH 队列和国家学校登记处相关联。所有新生儿都要采集干血斑（DBS）样本，这是根据新生儿筛查计划进行的。促甲状腺激素用于 CH 筛查。CH 的定义是筛查结果异常（DBS+）并接受左甲状腺素（LT4+）治疗，或筛查结果正常但在国家患者登记处被诊断为 CH 并接受 LT4 治疗（DBS-/ICD+/LT4+）。使用回归模型来研究学业成绩，即通过平均绩点和国家考试成绩来衡量。还进行了同胞分析，以解释未测量的家族因素。
有 448 名儿童 DBS+/LT4+，475 名儿童 DBS-/ICD+/LT4+。患有 CH 的儿童平均绩点较低，调整后的β值分别为-6.34（95%CI -11.7 至 -1.01）和-10.3（95%CI -15.5 至 -5.20），分别为筛查异常（DBS+/LT4+）和正常（DBS-/ICD+/LT4+）的儿童。CH 还与国家考试成绩较低相关，尤其是在数学方面。这些关联在同胞分析中仍然存在。
与没有 CH 的儿童以及他们的兄弟姐妹相比，患有 CH 的青少年的学业成绩略低。筛查结果正常、随后被诊断出的 CH 儿童在平均绩点和国家考试成绩方面的表现最低。
