Natural course of the congenital subclinical hypothyroidism does not affect physical and neuropsychiatric development of children

BACKGROUND: Congenital subclinical hypothyroidism is a condition made when a serum TSH is elevated with circulating thyroid hormone levels within their reference ranges, revealed as a result of neonatal screening. To date, the question of the effect of this condition on the physical and neuropsychic development of children remains open, in addition, there are no clear indications for the choice of therapeutic tactics and the start of substitution therapy.  

AIM: To evaluate the impact of therapeutic approaches on the neuropsychiatric and physical development of children with congenital subclinical hypothyroidism.  

MATERIALS AND METHODS: A statistical analysis of thyroid profile, physical and neuropsychiatric development indicators was carried out between two groups of patients with congenital subclinical hypothyroidism, depending on the therapy received.  

RESULTS: There was a statistically significant decrease in TSH compared with the baseline, as well as maintaining the initially normal level of free thyroxine in the group of patients receiving hormone replacement therapy, after re-testing and discontinuation of therapy. None of the patients included in the study were diagnosed with the development of manifest hypothyroidism during dynamic follow-up. There were no statistically significant differences in hight, target hight, BMI, neuro-psychiatric development between two groups. 

CONCLUSION: The first evidence was obtained of the absence of the effect of «elevated» TSH levels on the neuropsychological and physical development of children with congenital subclinical hypothyroidism during dynamic observation (at least the first 4 years of life), which gives the clinician additional arguments when discussing the choice of therapeutic tactics for congenital subclinical hypothyroidism. 

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