Peer-reviewed article
Effect of timely diagnosis and treatment on growth and body proportionality of children with congenital hypothyroidism.
Aditya Kochar, Harvinder Kaur, Devi Dayal ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study compared growth outcomes in 66 Indian children with congenital hypothyroidism (a preventable thyroid condition) who received treatment at different ages, against 64 healthy children. Children treated within 3 months had significantly better growth than those treated later, with late-treated children showing higher rates of stunting, underweight, and abnormal body proportions. The findings demonstrate that early diagnosis and treatment within the first 3 months is critical to prevent permanent growth deficits and developmental problems.
Key points
- 53% of children with congenital hypothyroidism had stunting compared to healthy controls
- Late-treated children (>3 months) had 67.7% severe stunting versus 11.4% in early-treated children
- Disproportionate body stature occurred in 71% of late-treated versus 42.9% of early-treated children
- Late-treated children had higher rates of microcephaly (35.5% vs 8.6%) and severe underweight (29% vs 2.9%)
- Early treatment ideally within first 3 months is essential to prevent growth and neurodevelopmental deficits
Limitations
This is a cross-sectional study comparing two treatment groups at a single time point rather than following children prospectively, so causality cannot be definitively established. The study does not provide details on long-term neurodevelopmental outcomes beyond physical measurements.
Abstract
BACKGROUND: Congenital hypothyroidism (CH) is a preventable cause of growth and neurodevelopmental deficits. In India, lack of universal newborn screening (NBS) delays diagnosis. This study examines how treatment timing influences growth, nutrition, and body proportionality in children with CH. METHODS: This cross-sectional study included 66 children with CH, aged under 5 years, receiving Levothyroxine(LT4) therapy for one year. Age and sex-matched 64 healthy children were also enrolled. Children with CH were stratified into early-treated (<3months) and late-treated (>3months) groups. Anthropometric measurements were converted to Z-scores using WHO standards. Body proportionality was assessed using: height-arm span difference, upper segment-to-lower segment (US: LS) ratio, Manouvrier's Indice Skélique (MIS). MIS classifies skeletal proportions as brachyskelia (short legs, long trunk; score ≤84.9), mesatyskelia (intermediate; 85.0-89.9), and macroskelia (long legs, short trunk; ≥90). RESULTS: Children with CH had significantly lower height-for-age (HAZ -2.31 ± 1.32 vs. -0.41 ± 0.96), weight-for-age (WAZ -1.98 ± 1.41 vs. -0.36 ± 1.02), and head circumference-for-age (HCZ -1.52 ± 1.28 vs. -0.21 ± 0.89) Z-scores compared with healthy controls (all p < 0.001). Stunting (HAZ < -2 SD) was present in 53% of children, while underweight (WAZ < -2 SD) was observed in 36.4%. Late-treated children had a higher prevalence of severe stunting (67.7% vs. 11.4%), severe underweight (29.0% vs. 2.9%), and microcephaly (35.5% vs. 8.6%) compared with early-treated children (p < 0.05). Disproportionate stature was observed in 71.0% of late-treated children compared with 42.9% of early-treated children (p < 0.05). US: LS ratio and Manouvrier's Index further confirmed greater skeletal disproportionality in late-treated children compared with early-treated children (p < 0.05). CONCLUSIONS: Delayed treatment in CH significantly impairs growth, increases skeletal disproportionality, and adversely affects neurocranial development. Early initiation of therapy-ideally within the first 3 months-is essential. These findings highlight the need for newborn screening in India.