[Transient congenital hypothyroidism: physiopathology and clinica]

Abstract

The fetus and the newborn are more sensitive than adults to a reduced environmental iodine supply, and in iodine-deficient areas, transient neonatal hypothyroidism is frequently observed. This transient thyroid failure may be associated with neonatal goiter and elevated serum thyroglobulin levels at birth. Borderline elevated neonatal serum TSH concentrations frequently occur in newborns in iodine deficient areas, and result in a higher recalling rate at the screening for congenital hypothyroidism. Minor defects in mental performances and neurological development are observed in children living in areas of mild to moderate iodine deficiency, and result from the concomitant effects of iodine deficiency in the mother during pregnancy and transient neonatal hypothyroidism. Endemic cretinism is the severe and irreversible neurological consequence of iodine deficiency during fetal and neonatal life. Iodine prophylaxis is highly effective in preventing the development of iodine deficiency disorders including transient neonatal hypothyroidism. Since iodine prophylaxis in Italy is inadequate, variable degrees of iodine deficiency are still present all-over the country, and are responsible of a higher incidence of transient neonatal hypothyroidism or hyperthyrotropinemia.