الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Background: Congenital hypothyroidism (CH) is the most common preventable
causes of mental retardation in children. Thyroid dysgenesis is the most common
cause of CH accounting for approximately 85% of all cases. Early treatment and high
compliance to therapy is an important prognostic factor for normal mental and
physical development in children with CH.
Aim of the work: The aim of this work is to allow identification of possible etiological
risk factors for congenital hypothyroidism and to evaluate the compliance of the
target families of patients with CH to therapy and the effect of non-compliance on
the physical and mental development.
Subjects and Methods: The study was descriptive cross- sectional design, which was
conducted in Endocrinology and Pediatric Outpatient Clinics in Sharkia Governorate
health insurance center. The study participants were 120 newborn and infant with
CH and their mothers (patients group), and 120 age matched volunteers of healthy
infants and children and their mothers (control group). Data were collected using
multi-structured questionnaires for determining socioeconomic state, clinical picture
at presentation, personal, family and obstetric history and Morisky Medication
Adherence Scale (MMAS 8) to assess patient compliance. Assessment of physical
growth through the anthropometric measurements, and assessment of mental
development by using Vineland-II scale for infant < 2 years, and Stanford-Binet 5
Intelligence scales, for individuals aged 2 years and more. The results of
investigations at diagnosis (initial TSH and T4) and during the follow up visits were
reviewed.
Results: About 85% of cases were permanent CH and about 15% of cases were
transient CH. The most common cause of CH is thyroid dysgenesis (80.6%) followed
by dyshormonogenesis (11.94%) and antithyroid drug intake (7.46%). An increased
risk for CH was detected in twins, prematurity, gestational age >40Ws, delivery with
CS, presence of additional birth defects. Father’s smoking, consanguinity, maternal
thyroid diseases and maternal drug use during pregnancy were also found to be
associated with CH. About two third of patient families were highly compliant to
therapy. There was highly significant difference between different compliance
grades and between patients and control groups as regard the parameters of the
metal and physical development. But no significant difference was found between
the highly compliant cases and control.
Conclusion: About 85% of cases were permanent CH. Compliance to L thyroxin
therapy in our patients and/or their family was found to be reasonable.