Endocrine Abstracts

JOINT386

Background: Congenital hypothyroidism (CH) is a common endocrine disease that can cause significant developmental delays and growth failure. The thyroid hormone is essential for adequate growth and development, especially throughout foetal life and early infancy. Newborn screening (NBS) programs have markedly enhanced the early identification and treatment of congenital hypothyroidism. The Indonesian Ministry of Health has relaunched NBS program by the end of 2023. The aim of this study is to compare the growth profile at birth, at the first time of diagnosis, and after treatment of the children with CH who were diagnosed without screening and who were diagnosed through the screening program.

Methods: 15 children who had been diagnosed with CH before the relaunching of the NBS program (non-NBS group) and 6 children who were diagnosed by the NBS program (NBS group) were included. fT4, TSH, weight, and height data were obtained from the medical record. Weight and height were transformed into z-scores standard deviation (SDS) according to the WHO growth chart. The data were processed with independent t-test using RStudio, with P < 0.05 considered significant.

Results: The mean age of diagnosis in the non-NBS group was 877 days, and in the NBS group was 24.6 days old. Average fT4 in the non-NBS group is 0.233 ng/dl, and in the NBS group is 0.52 ng/dl. The mean of the TSH level in the non-NBS group is 322.78 mLu/l, and in the NBS group, it is 228.9 mLu/L. There are no differences between birth weight SDS and birth length SDS between the non-NBS group vs. the NBS group (-0.11 vs. -0.92; P = 0.16) and (-0.14 vs. -0.41; P = 0.56), respectively. There are differences in weight SDS between the non-NBS group vs. the NBS group (-2.73 vs. -0.37; P < 0.01) and no differences in height SDS (-2.72 vs. -0.51; P = 0.08). Even after both groups were adequately treated, there are still differences in weight SDS and height SDS in the non-NBS group vs. the NBS group (-2.14 vs. -0.6; P < 0.05) and (-2.5 vs. -0.25; P < 0.05).

Conclusions: Primary congenital hypothyroidism is initially asymptomatic, the diagnosis can be delayed without screening, and the child may be exposed to hypothyroid conditions for a long time, leading to growth failure. Early diagnosis and treatment of congenital hypothyroidism are essential for improving growth and developmental outcomes. The optimal growth potential can be achieved through continuous monitoring and appropriate management.