Intellectual outcome at 12 years of age in congenital hypothyroidism

Background: The intellectual outcome in children with congenital hypothyroi dism detected by neonatal screening is generally goad: however, subtle neur ological dysfunctions, subnormal IQ, or both, have been reported. Objective: To evaluate the intellectual outcome in 12-year-old patients wit h congenital hypothyroidism, detected by neonatal screening, in an attempt to identify factors that may affect intellectual development. Methods: The intelligence quotient (IQ) of 40 children with congenital hypo thyroidism was evaluated at 12 years of age, using the Wechsler Intelligenc e Scale for Children - Revised, and compared with the IQ of 40 healthy sibl ings (control group). Results: The mean IQ score (88.4 +/- 13.1) was not significantly different from that of the control group (93.4 +/- 10.7). Thirteen patients showed su bnormal IQ score (77.4 +/- 4.9) compared with their siblings (86.7 +/- 9.6; P < 0.0001) and with the other patients (96.1 +/- 9.6; P < 0.0001). The lo w IQ score was associated with lower serum concentrations of thyroxine at d iagnosis, poor treatment compliance during follow-up and lower familial IQ. Interviews with parents of children with congenital hypothyroidism reveale d that a refusal to acknowledge the disease was linked to poor attention to the child's emotional life and to poor treatment compliance in some cases (11%), Conclusion: Even though the mean IQ score in patients with congenital hypot hyroidism falls within normal for the control population, low IQ scores may be present in patients with severe hypothyroidism, inadequate compliance t o replacement therapy during follow-up and poor parental pedagogic attitude .