Developmental scores in offspring of women with subclinical hypothyroidism in pregnancy are affected by gender and thyrotropin cutoff.

OBJECTIVES: Subclinical hypothyroidism (SCH) is defined by elevated thyrotropin (TSH) and normal level of thyroxine (T4). The definition of SCH and the cutoff for TSH normality in pregnancy are debated. In the present study, we assess offspring perinatal outcome, anthropometrics and early development in relation to different TSH levels. METHODS: An observational study with 77 singleton-pregnant women included by thyroid screening before a planned cesarean section. Two TSH-cutoffs (3.0 and 3.7 mIU/L) defined euthyroid and SCH groups, and were applied to evaluate offspring anthropometrics, complication rates (maternal blood loss, Apgar-score, cord arterial-pH, admission to neonatal intensive care unit, perinatal hypoglycemia) and offspring development. Development was evaluated by Bayley-III test in a subsample at age 6 months (n=27) and 15 months (n=22). RESULTS: Prevalence of SCH was 31.2 % at TSH-cutoff 3.0 mIU/L, and 16.9 % at TSH-cutoff 3.7 mIU/L. No differences in complications and anthropometrics were observed. In Bayley-III tests, cognitive score was decreased at 6 months (p=0.012) and at 15 months (p=0.056) by applying TSH-cutoff 3.0 mIU/L. At cutoff 3.7 mIU/L, motor score was decreased at 15 months (p=0.020). Male offspring had significantly lower cognitive scores at age 6 and 15 months (TSH-cutoff 3.0 mIU/L), and motor scores at age 15 months (TSH-cutoff 3.7 mIU/L). CONCLUSIONS: The importance of the definition of thyroid normality in pregnancy is underlined. This study suggests that a gender-effect might be present in maternal thyroid disease, and that developmental differences exist if TSH-cutoff is low. Further research is needed.

[Diagnosis of developmental dyspraxia].

In the absence of any known neurological condition or intellectual impairment, dyspraxia, also known as developmental coordination disorder, should be considered. Dyspraxia is the inability to plan, organize and execute movements. At all ages, dyspraxia can be congenital or acquired. While some learn to cope with their motor difficulties over the years, the majority will retain them as adults. Children with significant functional impairment should be identified and assessed as early as possible, since failure to address the motor and other commonly associated (co-morbid) features may have major consequences in adult life.

[Causes of mental retardation in children of immigrant background. A registry study of the occurrence of consanguinity among parents of mentally retarded children at the Center for Handicapped, Glostrup hospital, county of Copenhagen]. / Arsager til mental retardering hos børn med indvanderbaggrund. En registerstudie over forekomsten af konsangvinitet blandt foraeldrene til mentalt retarderede børn i Københavns Amt tilknyttet Center for Handicappede, Amtssygehuset i Glostrup.

INTRODUCTION: In the County of Copenhagen the treatment of mentally retarded (MR) children is centralised in the Center for Handicapped (CFH). The aim of this study was to elucidate whether the frequency of MR is higher in children from ethnic minorities than in the background population and whether an increase could be ascribed to inbreeding. MATERIAL AND METHODS: The medical records of children with a non-Danish family name and where both parents were from countries other than Denmark were studied. RESULTS: A significant increase in the frequency of MR were found in the children from ethnic minorities: 16.6% of the children seen at CFH had an ethnic background compared to 14% in the background population, making a surplus of 18.5% more than expected. When a family was inbred other family members had Mr in 43.0%, whereas more family members with MR were found in only 14.2% of the families with no inbreeding. In the consanguineous families we found possible aetiological diagnoses in 21.5% of the children compared to 49% in the non-consanguineous families. In the entire group of children from ethnic minorities, we found Down's syndrome in 3.2% compared to 10.7% in Danish children with MR. DISCUSSION: There is a surplus of MR in children from ethnic minorities in the County of Copenhagen. The causes are not known, nor are aetiological factors for MR for a great part of the children. Consanguinity is likely to be a risk factor for MR, especially if it is already present in the family. This conforms with previously published data from other countries.

Health-related quality of life in adult survivors of childhood sarcoidosis.

AIM: To describe health-related quality of life (hrQOL) in adult subjects who had sarcoidosis in childhood. METHODS: Forty-six children (24 boys), all ethnic Danes