Clinics in Developmental Medicine

Acid-base status at birth and neurodevelopmental outcome at four and one-half years.

Filter paper blood samples taken routinely from 100 239 newborn infants were radioimmunoassayed five years later for plasma thyrotrophin concentrations In 32 cases (003%) these were found to be raised Thirty one of these children were traced and subjected to follow up examination by a paediatrician and a psychologist Of the 31 children, 15 were found to have been receiving treatment for congenital hypothyroidism since a median of 5 months of age (diagnosed group) Of the 16 others, seven children were found to have raised serum thyrotrophin concentrations and were classified as hypothyroid (undiagnosed group) The remaining nine children were euthyroid Children in the diagnosed group had a mean Griffiths developmental quotient of 87 (control value 103; p less than 001), and five out of 13 showed impaired neurological development Of the remainder, those in the undiagnosed group had a mean developmental quotient of 100 and those in the euthyroid group a mean developmental quotient of 107 In this study achieving a detection rate of congenital hypothyroidism of one in 3000 in a neonatal screening programme resulted in overdiagnosis of about a quarter of patients considered to have true positive findings This was outweighed, however, by the early identification of all infants with the disease

https://www.bmj.com/content/bmj/289/6453/1171.full.pdf

Incidence of congenital hypothyroidism: retrospective study of neonatal laboratory screening versus clinical symptoms as indicators leading to diagnosis.

Hypertension during pregnancy with and without specific treatment; the development of the children at the age of four years.

UMMARY
Forty-three children born in the Nottingham area in 1981 and weighing >1501g who had received treatment in the neonatal intensive care unit were followed up on entry to primary school at the age of five years. All were apparently normal, with no observable handicap or need for special educational provision. Their results on the McCarthy Scales of Children's Abilities were compared with those of closely matched classmates and significant differences were found between the two groups on all six scales, most markedly on the General Cognitive Index.

ReSUMe
Capacites des enfants de tres faible poids de naissance compares avec leurs condisciples scolaires Quarante-trois enfants nes dans la region de Nottingham en 1981 et avec un poids de naissance <1501g, ayant recu un traitement dans une unite de soins intensifs neonataux ont ete suivis jusqu'a l'entree a l'ecole primaire a l'âge de cinq ans. Tous etaient apparemment normaux sans handicap notable ou besoin d'une education en milieu specialise. Leurs resultats aux Echelles de McCarthy d'aptitude infantile ont ete compares avec ceux de condisciples etroitement apparies et des differences significatives ont ete trouvees entre les deux groupes aux six echelles, tout specialement a l'index general de connaissances.

ZUSAMMENFASSUNG
Die Leistungen von Kindern mit sehr niedrigem Geburtsgewicht im Vergleich zu denen ihrer Klassenkameraden

43 Kinder, die 1981 in Nottingham geboren worden waren, <1501g gewogen haben und auf der Neugeborenenintensivstation versorgt worden waren, wurden bis zur Einschulung im Alter von funf Jahren kontrolliert. Alle erschienen normal, ohne erkennbare Behinderung und ohne Bedarf an Sonderschulung. Ihre Testergebnisse bei den McCarthy Scales of Children's Abilities wurden mit denen entsprechender Klassenkameraden verglichen, und es fanden sich zwischen den beiden Gruppen signifikante Unterschiede bei allen sechs Scales, besonders beim General Cognitive Index.

RESUMEN
Las capacidades de nihos nacidos con muy bajo peso, en comparacion con sus compaheros de clase Cuarenta y tres ninos nacidos en el area de Nottingham en 1981, pesando menos de 1501g y que habian recibido tratamiento en una UVI neonatal fueron seguidos hasta su ingreso en la escuela primaria a la edad de cinco anos. Todos eran aparentemente normales sin ninguna vinusvalia observable, ni necesidad de education especial. Sus resultados en las McCarthy Scales of Children's Abilities fueron comparados con los de los compafieron de clase de caracteristicas semejantes. Se hallaron diferencias significativas entre los dos grupos especialmente en el General Cognitive Index.

G. Sleigh

Papers

A method of developmental assessment at four years and some associated findings.