Objectives. The aim of the current study was to investigate the growth status of CH, generate specialized growth charts of CH infants, and compare them with their counterparts of regional normal infants. Methods. In this prospective cohort study, 760 (345 girls and 415 boys) neonates born in 2002–2009 diagnosed by neonatal CH screening program in Isfahan were followed up from the time of diagnosis. 552 healthy children were recruited as a control group. The empirical 3rd, 15th, 50th, 85th, and 97th percentiles for height, weight, and head circumference of both sexes were determined and compared with their counterpart values of the control group. The relative frequency of patients with impaired growth for each studied variable was determined. Also, specialized growth charts of CH patients were generated. Results. The percentiles of weight, height, and head circumference of studied patients are significantly different from regional healthy children ( ). The relative frequency of impaired head circumference was decreased to less than 3% at the 3rd year of age and for height it reached gradually 3% and 9% at the 5th year of age for boys and girls, respectively ( ); however for weight still it was statistically more than 3% in both sexes. Conclusion. CH patients had impaired growth development which was improved during follow up, but the catch-up time was earlier for head circumference and later for weight. 1. Introduction Thyroid hormones are essential for appropriate growth and development during fetal life and neonatal period [1]. Congenital hypothyroidism (CH), the most common neonatal endocrine and metabolic disorder, is considered as the preventable cause of mental and growth retardation [2]. Congenital hypothyroidism (CH) is the most common congenital endocrine disorder, affecting 1 in 3000 to 4000 newborns. The prevalence varies depending on the race/ethnicity and the method of screening [2–7]. Although screening programs ensure early treatment, developmental problems in relation to physical and mental outcomes are still reported in follow-up studies in developing and even in developed nations [8–10]. CH screening in Isfahan, one of the biggest central provinces in Iran, has been started in 2002 as a pilot study which continued till 2005 and because of high prevalence of the disorder, that is, 1？:？370 in 2002 [7] and 1？:？748 in 2009 [11], it was adapted as a nationwide screening program in Iran and is continuing till now [11]. Many studies have already been performed and published regarding the high prevalence and its environmental, genetic, and
References
[1]
P. Bain and J. E. Toublanc, “Adult height in congenital hypothyroidism: prognostic factors and the importance of compliance with treatment,” Hormone Research in Paediatrics, vol. 58, no. 3, pp. 136–142, 2002.
[2]
M. V. Rastogi and S. H. LaFranchi, “Congenital hypothyroidism,” Orphanet Journal of Rare Diseases, vol. 5, no. 1, article no. 17, 2010.
[3]
S. R. Rose, R. S. Brown, T. Foley et al., “Update of newborn screening and therapy for congenital hypothyroidism,” Pediatrics, vol. 117, no. 6, pp. 2290–2303, 2006.
[4]
M. Rosenthal, G. M. Addison, and D. A. Price, “Congenital hypothyroidism: increased incidence in Asian families,” Archives of Disease in Childhood, vol. 63, no. 7, pp. 790–793, 1988.
[5]
M. Hashemipour, S. Hovsepian, R. Kelishadi et al., “Permanent and transient congenital hypothyroidism in Isfahan-Iran,” Journal of Medical Screening, vol. 16, no. 1, pp. 11–16, 2009.
[6]
M. Haghshenas, Y. Zahed Pasha, M. Ahmadpour-Kacho, and S. Ghazanfari, “Prevalence of permanent and transient congenital hypothy-roidism in Babol City-Iran,” Medicinski Glasnik, vol. 9, no. 2, pp. 341–344, 2012.
[7]
M. Hashemipour, M. Amini, R. Iranpour et al., “Prevalence of congenital hypothyroidism in Isfahan, Iran: results of a survey on 20,000 neonates,” Hormone Research, vol. 62, no. 2, pp. 79–83, 2004.
[8]
R. S. Olney, S. D. Grosse, and R. F. Vogt Jr., “Prevalence of congenital hypothyroidism—current trends and future directions: workshop summary,” Pediatrics, vol. 125, supplement 2, pp. S31–S36, 2010.
[9]
M. J. E. Kempers, L. Van Der Sluijs Veer, R. W. G. Nijhuis-Van Der Sanden et al., “Neonatal screening for congenital hypothyroidism in The Netherlands: cognitive and motor outcome at 10 years of age,” Journal of Clinical Endocrinology and Metabolism, vol. 92, no. 3, pp. 919–924, 2007.
[10]
D. Leonardi, N. Polizzotti, A. Carta et al., “Longitudinal study of thyroid function in children with mild hyperthyrotropinemia at neonatal screening for congenital hypothyroidism,” Journal of Clinical Endocrinology and Metabolism, vol. 93, no. 7, pp. 2679–2685, 2008.
[11]
M. Hashemipour, S. Hovsepian, R. Kelishadi et al., “Permanent and transient congenital hypothyroidism in Isfahan-Iran,” Journal of Medical Screening, vol. 16, no. 1, pp. 11–16, 2009.
[12]
S. R. Rose, R. S. Brown, T. Foley et al., “Update of newborn screening and therapy for congenital hypothyroidism,” Pediatrics, vol. 117, no. 6, pp. 2290–2303, 2006.
[13]
M. R. Sabri, H. Shahriari, and M. Hashemipour, “Congenital cardiac malformations in congenital hypothyroid patients in Isfahan,” Journal of Research in Medical Sciences, vol. 11, no. 4, pp. 234–239, 2006.
[14]
M. Hashemipour, P. Nasri, S. Hovsepian et al., “Urine and milk iodine concentrations in healthy and congenitally hypothyroid neonates and their mothers,” Endokrynologia Polska, vol. 61, no. 4, pp. 371–376, 2010.
[15]
M. Hashemipour, M. Amini, M. Talaie et al., “Parental consanguinity among parents of neonates with congenital hypothyroidism in Isfahan,” Eastern Mediterranean Health Journal, vol. 13, no. 3, pp. 567–574, 2007.
[16]
A. Adibi, M. Haghighi, S. R. Hosseini, M. Hashemipour, M. Amini, and S. Hovsepian, “Thyroid abnormalities among first-degree relatives of children with congenital hypothyroidism: an ultrasound survey,” Hormone Research, vol. 70, no. 2, pp. 100–104, 2008.
[17]
F. Mahjoubi, M. M. Mohammadi, M. Montazeri, M. Aminii, and M. Hashemipour, “Mutations in the gene encoding paired box domain (PAX8) are not a frequent cause of congenital hypothyroidism (CH) in Iranian patients with thyroid dysgenesis,” Arquivos Brasileiros de Endocrinologia e Metabologia, vol. 54, no. 6, pp. 555–559, 2010.
[18]
J. J. Bongers-Schokking, H. M. Koot, D. Wiersma, P. H. Verkerk, and S. M. P. F. De Muinck Keizer-Schrama, “Influence of timing and dose of thyroid hormone replacement on development in infants with congenital hypothyroidism,” Journal of Pediatrics, vol. 136, no. 3, pp. 292–297, 2000.
[19]
NECH Collaborative, “Neonatal hypothyroidism screening: status of patients at 6 years of age,” Journal of Pediatrics, vol. 107, no. 6, pp. 915–919, 1985.
[20]
D. B. Grant, “Growth in early treated congenital hypothyroidism,” Archives of Disease in Childhood, vol. 70, no. 6, pp. 464–468, 1994.
[21]
D. A. Fisher, “Disorders of the thyroid in the newborn and infant,” in Pediatric Endocrinology, M. A. Sperling, Ed., pp. 51–70, Saunders, Philadelphia, Pa, USA, 1st edition, 1996.
[22]
“Screening for congenital hypothyroidism,” Thyroid, vol. 13, no. 14, pp. 87–94, 2003.
[23]
R. Z. Klein and M. H. Mitchell, “Hypothyroidism in infants and children,” in The Thyroid, L. E. Braverman and R. D. Utiger, Eds., pp. 973–988, Lippincott Williams & Wilkins, Philadelphia, 8th edition, 2000.
[24]
J. E. Frank, J. E. Faix, R. J. Hermos et al., “Thyroid function in very low birth weight infants: effects on neonatal hypothyroidism screening,” Journal of Pediatrics, vol. 128, no. 4, pp. 548–554, 1996.
[25]
M. de Onis and B. Woynarowska, “WHO child growth standards for children 0-5 years and the possibility of their implementation in Poland,” Medycyna Wieku Rozwojowego, vol. 14, no. 2, pp. 87–94, 2010.
[26]
S. Vazirian and A. Sedighnezhad, “Update of growth percentiles for children of an Iranian population,” Archives of Iranian Medicine, vol. 6, no. 3, pp. 163–169, 2003.
[27]
E. Kik and A. Noczyńska, “Evaluation of physical development of children with congenital hypothyroidism detected in the screening test-personal observations,” Pediatric Endocrinology, Diabetes, and Metabolism, vol. 17, no. 2, pp. 96–106, 2011.
[28]
A. Chiesa, L. G. De Papendieck, A. Keselman, J. J. Heinrich, and C. Bergada, “Growth follow-up in 100 children with congenital hypothyroidism before and during treatment,” Journal of Pediatric Endocrinology, vol. 7, no. 3, pp. 211–217, 1994.
[29]
L. Moschini, P. Costa, and E. Marinelli, “Longitudinal assessment of children with congenital hypothyroidism detected by neonatal screening,” Helvetica Paediatrica Acta, vol. 41, no. 5, pp. 415–424, 1986.
[30]
H. Bucher, A. Prader, and R. Illig, “Head circumference, height, bone age and weight in 103 children with congenital hypothyroidism before and during thyroid hormone replacement,” Helvetica Paediatrica Acta, vol. 40, no. 4, pp. 305–316, 1985.
[31]
H. Sato, N. Sasaki, K. Aoki, Y. Kuroda, and T. Kato, “Growth of patients with congenital hypothyroidism detected by neonatal screening in Japan,” Pediatrics International, vol. 49, no. 4, pp. 443–446, 2007.
[32]
Q. Sun, Y. L. Chen, Z. B. Yu, et al., “Long-term consequences of the early treatment of children with congenital hypothyroidism detected by neonatal screening in Nanjing, China: a 12-year follow-up study,” Journal of Tropical Pediatrics, vol. 58, no. 1, pp. 79–80, 2012.
[33]
A. G. Agulló, E. Vicens-Calvet, A. C. Lezcano, M. B. Esteve, and N. P. Vilalta, “Growth and maturation in the patients with congenital hypothyroidism detected by the neonatal screening program in Catalonia, Spain (1986–1997),” Medicina Clínica, vol. 134, no. 7, pp. 287–295, 2010.
[34]
M. Adachi, Y. Asakura, and K. Tachibana, “Final height and pubertal growth in Japanese patients with congenital hypothyroidism detected by neonatal screening,” Acta Paediatrica, vol. 92, no. 6, pp. 698–703, 2003.
[35]
A. Morin, L. Guimarey, M. Apezteguía, M. Ansaldi, and Z. Santucci, “Linear growth in children with congenital hypothyroidism detected by neonatal screening and treated early: a longitudinal study,” Journal of Pediatric Endocrinology and Metabolism, vol. 15, no. 7, pp. 973–977, 2002.
[36]
V. Siragusa, A. Terenghi, G. F. Rondanini et al., “Congenital hypothyroidism: auxological retrospective study during the first six years of age,” Journal of Endocrinological Investigation, vol. 19, no. 4, pp. 224–229, 1996.
[37]
S. Heyerdahl, A. Ilicki, J. Karlberg, B. F. Kase, and A. Larsson, “Linear growth in early treated children with congenital hypothyroidism,” Acta Paediatrica, vol. 86, no. 5, pp. 479–483, 1997.
[38]
M. Salerno, M. Micillo, S. Di Maio et al., “Longitudinal growth, sexual maturation and final height in patients with congenital hypothyroidism detected by neonatal screening,” European Journal of Endocrinology, vol. 145, no. 4, pp. 377–383, 2001.
[39]
S. M. Ng, S. C. Wong, and M. Didi, “Head circumference and linear growth during the first 3 years in treated congenital hypothyroidism in relation to aetiology and initial biochemical severity,” Clinical Endocrinology, vol. 61, no. 1, pp. 155–159, 2004.
[40]
M. Hashemipour, S. Hovsepian, and R. Kelishadi, “High prevalence of congenital hypothyroidism in Isfahan: do familial components have a role?” Advanced Biomedical Research, vol. 1, no. 1, article 37, 2012.
