Intellectual development of children with congenital hypothyroidism

The purpose of the study was to search for causes that exert a negative effect on the mental development of patients with con­genital hypothyroidism (CH). A total of 85 children aged 5-17 years (65 patients with CH and 20 healthy individuals of the same age from their families) were examined. Their mental de­velopment was assessed by the D. Veksler test in the presence of clinical and hormonal compensation. The results have demon­strated that the start of therapy at month 1 of life provides high adaptive capacities and results in the normal level of mental development in children with CH (the mean IQ, 103±4 scores). The adequacy of the therapy performed also affects the mental development of patients with CH in future: children with normal intellect (IQ > 90 scores) received adequate hormonal replace­ment therapy within the first year of life in 90% of cases whereas hormonal compensation within the first year of life was noted only in 38% of the children with borderline intellectual deficiency (IQ = 70-89 scores). Perinatal pathology was more frequently de­tected in children with mental retardation: in children with oli­gophrenia and those with normal intellect, their maternal path­ological pregnancy was observed in 56 and 22%, respectively. Birth asphyxia was noted in 33% versus 15%. Familial and so­cialfactors played a role (but not decisive) in the formation of the intellectual level of a child with CH. It is concluded that the time of initiation and the adequacy of therapy play the leading role in the formation of intellect. The authors 'findings show it necessary to optimize a follow-up system for children with CH: a stricter clinical and hormonal monitoring of patients by an endocrinol­ogist and consulting of children with CH by a neurologist and a medical psychologist from their infancy.

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