FACTORS AFFECTING THE INTELLECTUAL PROGNOSIS IN CONGENITAL HYPOTHYROIDISM (C.H.)

Abstract

40 girls and 12 boys with CH. (8 athyreosis, 33 ectopics, 11 anatomically normal gland) whose treatment began at day : 29 ± 12 (mean ± SD) were followed for at least 4 years and in 13 cases for 7 years. The results of the Brunet-Lezine test at 0.5, 1, and 2 years; the Termann-Merill at 4 years and the WICSR test at 7 years, were all within the normal range but with a wide scatter : range 85-145 at 4 years, 95-133 at 7 years. The factors involved in this scatter were investigated. The following factors had no influence : clinical evidence of hypothyroidism at diagnosis, the presence and duration of neonatal jaundice, the initial levels of T4 and TSH, the etiology after 2 years, the date of starting treatment provided that this occured within the 2 first months of life. The following factors had a positive influence on the outcome : the presence of the 2 epiphysis of the knee (p <.025), socioeconomic level of parents (Graffar) : high medium vs medium (p <.05), vs low medium (p < .005) and good hormonal control during the first year (p <.025) and the following years (p<.05). The presence of psychological problems were predictive of a comparatively poor outcome : mild problems (p<.005) and severe problems (p <.0005) mild vs severe (p <.05). The development of psychological problems are associated with an initial hospitalization (p < .001) and the duration of it (p < .025). Postnatal factors are predominant which emphasises the need for good medical and familial care.