Crecimiento y maduración de los pacientes con hipotiroidismo congénito detectados por el programa de cribado neonatal en Cataluña (1986–1997) / Growth and maturation in the patients with congenital hypothyroidism detected by the neonatal screening program in Catalonia, Spain (1986–1997)

Fundamento y objetivo: En muchos países se han establecido programas de detección precoz del hipotiroidismo congénito (HC) que consiguen un crecimiento y un cociente intelectual normales. El objetivo de este estudio es realizar el seguimiento de los casos de HC detectados mediante el programa de detección precoz del HC en Cataluña. Pacientes y método: El estudio es descriptivo, longitudinal, de una serie de 136 casos de HC detectados mediante el programa de detección precoz en Cataluña del año 1986 al año 1997 y controlados en el Hospital Materno-infantil Vall d´Hebron de Barcelona. Se han valorado los parámetros que indican la intensidad y duración del hipotiroidismo neonatal. Se ha hecho el seguimiento del crecimiento y una exploración psicológica (test de McCarthy y la escala de inteligencia de Wechsler para niños). Resultados: Los niños (30 casos, el 22,1%) y las niñas (106 casos, el 77,9%) con HC de este estudio han tenido un crecimiento, peso e índice de masa corporal que no son distintos de los de la población actual de Barcelona. La talla se ha situado 0,5 DE por encima de los valores de Tanner de 1966 y el índice de masa corporal se ha situado una DE por encima de los valores de Roland-Cachera de 1982. Esta aceleración secular del crecimiento se ha observado en todos los países desarrollados. En una muestra del 37,5% de los casos, el desarrollo psicológico no ha diferido del de la población de referencia. Sin embargo, una mayor intensidad del hipotiroidismo neonatal y la normalización más tardía de éste ha correlacionado negativamente con la puntuación en los test psicológicos. Conclusiones: Una vez conseguida la normalización del crecimiento y del desarrollo psicológico, se debería optimizar el programa de detección precoz para el HC en Cataluña e iniciar el tratamiento lo más precozmente posible para evitar que algunos niños no alcancen su potencial intelectual completo (AU)

Background and objective: Many countries have developed screening programs for CH that bring about a normal somatic and psychological development. The aim of this study is to evaluate the evolution of cases detected by the screening program of congenital hypothyroidism in Catalonia. Patients and methods: The was a descriptive, longitudinal study of a series of 136 cases of congenital hypothyroidism detected by the screening program in Catalonia from 1986 to 1997 and who had been checked in the Maternal-infantile Vall d´Hebron Hospital in Barcelona. Follow-up was carried out for growth and a psychological exploration was performed (McCarthy test and WISC-R).Results Males (30 cases, 22.1%) and females (106 cases, 77.9%) with congenital hypothyroidism of this study had a height, weight and BMI that were not different from those of the current population of Barcelona. Height was 0.5 SD above the Tanner reference values of 1966 and BMI was one SD above the Roland-Cachera reference values of 1982. This secular acceleration of growth has been observed in all developed countries. Results: In a sample of 37.5% of the cases, psychological development did not differ from that of the reference population. However, a greater intensity of neonatal hypothyroidism and its most delayed normalization correlated negatively with the score in the psychological tests. Conclusions: Once normalization of growth and psychological development are achieved, the screening program of congenital hypothyroidism in Catalonia should be optimized by initiating treatment as soon as possible to avoid the possibility that some children do not reach their complete intellectual potential (AU)

[Growth and maturation in the patients with congenital hypothyroidism detected by the neonatal screening program in Catalonia, Spain (1986-1997)]. / Crecimiento y maduración de los pacientes con hipotiroidismo congénito detectados por el programa de cribado neonatal en Cataluña (1986-1997).

BACKGROUND AND OBJECTIVE: Many countries have developed screening programs for CH that bring about a normal somatic and psychological development. The aim of this study is to evaluate the evolution of cases detected by the screening program of congenital hypothyroidism in Catalonia. PATIENTS AND METHODS: The was a descriptive, longitudinal study of a series of 136 cases of congenital hypothyroidism detected by the screening program in Catalonia from 1986 to 1997 and who had been checked in the Maternal-infantile Vall d'Hebron Hospital in Barcelona. Follow-up was carried out for growth and a psychological exploration was performed (McCarthy test and WISC-R). RESULTS: Males (30 cases, 22.1%) and females (106 cases, 77.9%) with congenital hypothyroidism of this study had a height, weight and BMI that were not different from those of the current population of Barcelona. Height was 0.5 SD above the Tanner reference values of 1966 and BMI was one SD above the Roland-Cachera reference values of 1982. This secular acceleration of growth has been observed in all developed countries. In a sample of 37.5% of the cases, psychological development did not differ from that of the reference population. However, a greater intensity of neonatal hypothyroidism and its most delayed normalization correlated negatively with the score in the psychological tests. CONCLUSIONS: Once normalization of growth and psychological development are achieved, the screening program of congenital hypothyroidism in Catalonia should be optimized by initiating treatment as soon as possible to avoid the possibility that some children do not reach their complete intellectual potential.