• Influence of functional disorders of pituitari-thyroid system on neuropsychological development and neurological status of infants
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Influence of functional disorders of pituitari-thyroid system on neuropsychological development and neurological status of infants

SOVREMENNAYA PEDIATRIYA. 2015.2(66):105-108; doi 10.15574/SP.2015.65.105

 

Influence of functional disorders of pituitari-thyroid system on neuropsychological development and neurological status of infants

 

Mamenko M. E., Shleyenkova A. A., Belih N. A., Doncova E. M.

National Medical Academy of Postgraduate Education P. L. Shupyk, Kiev, Ukraine

Kharkov Medical Academy of Postgraduate Education, Ukraine

PI «Lugansk State Medical University», Lugansk, Ukraine

Lugansk regional children's home № 2, Severodonetsk, Ukraine

 

The objective of investigation. To study the relationship between the functional state of the pituitary-thyroid axis, the state of the nervous system and the level of mental development of young children.

 

Materials and Methods. In the original survey 123 children aged from 2 to 3.5 months participated, which came to the nurture children's home during the period from 2010 to 2012 as children deprived of parental care.

 

Results and Discussion. The high frequency of neurological disorders in children deprived of parental care was demonstrated (94.1±2.2%). The most commonly the syndrome of static, kinetic, mental and pre-speech retardation was diagnosed (49.2±4.7%, p<0.001). One&third of surveyed children proved to have minimal thyroid dysfunction (TSH-levels over 4.0 mU/L in 27.1±4.1% of cases). Reference intervals considered content TSH 0.3 mUm/L to 4.0 mU/L. Issues of normal values of TSH remains disputable. According to research NHANES III JG Hollowel and collaborators normal levels of TSH in serum are within 1.18–1.40 mU/L, and more than 95% of the healthy population have TSH above 2.5 mU/L. Given that L. Wartofsky and RA Dickey (2005) believe that normal levels of TSH levels must accept values 0.3–2.5 mU/L. According to Joseph E. Rain and Malcolm D.C. Donaldson in children aged 2 to 20 weeks TSH was normal interval from 1.7–9.1 mU/L, but in terms of TSH above 6.0 mU/L they recommend more tests and follow-up. The most often changes in thyroid status were detected in children with the syndrome of static, kinetic, mental and pre-speech retardation (32.7±6.1%, p<0.05).

 

Conclusions. The vast majority of infants at the orphanage have neurological damage caused by perinatal pathology (94.1±2.2%, 111/118). The structure of neurological disorders recovery period dominated syndrome of static, kinetic, mental and pre-speech retardation 49.2±4.7% (p<0.001). Minimal thyroid dysfunction was detected in 27.1±4.1% (32/118) children. The most deep changes in functional activity of pituitary-thyroid system were observed in children with the syndrome of static, kinetic, mental and pre-speech retardation. Reduced activity of the pituitary-thyroid axis has a negative impact on the neuro-psychological development of the child, reflecting the negative correlation (p=-0.68) between TSH and ratio of mental development, and a direct correlation (p=0.52) between the level of free T4 and ratio of mental development.

 

Key words: neurologic status; psychological development, pituitary-thyroid system; young children.

 

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