ESPE Yearbook of Paediatric Endocrinology

J Pediatr. 2024 Dec:275:114240. doi: 10.1016/j.jpeds.2024.114240. PMID: 39151600

Brief Summary: This population-based sibling control study assessed school performance in Swedish adolescents with congenital hypothyroidism (CH) born between 1982 and 1997; in this period, the threshold for an abnormal newborn screening for CH test was lowered from 25 mU/L blood to 20 mU/L blood. Among 923 CH patients, 448 were identified via newborn screening (DBS) and treated with levothyroxine (LT4) subsequently (DBS⁺/LT4⁺), and 475 were treated for CH (ICD) but were not detected by screening (DBS⁻/ICD⁺/LT4⁺). Compared with the general population and siblings, adolescents in the DBS⁺/LT4⁺ group had similar academic outcomes, while those in the DBS⁻/ICD⁺/LT4⁺ group showed lower grades in core subjects and reduced eligibility for upper secondary education.

In essence, Gunnerbeck et al replicated the findings of Lain et al who found that Australian infants with neonatal TSH levels just below the then applied newborn screening thresholds, who were typically not diagnosed or treated, had an increased risk of poor educational and developmental outcomes [1].Both studies highlight the importance of early detection and treatment of mild cases of CH to support cognitive and academic development.

Reference: 1. Lain SJ, Bentley JP, Wiley V, Roberts CL, Jack M, Wilcken B, Nassar N. Association between borderline neonatal thyroid-stimulating hormone concentrations and educational and developmental outcomes: a population-based record-linkage study. Lancet Diabetes Endocrinol. 2016 Sep;4(9):756-765. doi: 10.1016/S2213-8587(16)30122-X. PMID: 27453174.