{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:05:11Z","timestamp":1790946311812,"version":"4.1.0"},"reference-count":34,"publisher":"The Endocrine Society","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Congenital hypothyroidism, occurring in 1:3000 newborns, is one of the most common preventable causes of mental retardation. Neurodevelopmental outcome is inversely related to the age of diagnosis and treatment. Infants detected through newborn screening programs and started on l-T4 in the first few weeks of life have a normal or near-normal neurodevelopmental outcome. The recommended starting dose of l-T4 (10\u201315 \u03bcg\/kg \u00b7 d) is higher on a weight basis than the dose for children and adults. Tailoring the starting l-T4 dose to the severity of the hypothyroidism will normalize serum T4 and TSH as rapidly as possible. It is important to obtain confirmatory serum thyroid function tests before treatment is started. Further diagnostic studies, such as radionuclide uptake and scan and ultrasonography, may be performed to determine the underlying cause of hypothyroidism. Because results from these tests generally do not alter the initial treatment decision, however, these diagnostic studies are rarely indicated. The developing brain has a critical dependence on thyroid hormone for the first 2\u20133 yr of life; thus, monitoring occurs at more frequent intervals than in older children and adults. Serum free T4 and TSH should be checked at intervals frequent enough to ensure timely adjustment of l-T4 dosing and to keep serum free T4 and TSH levels in target ranges. Given the success of early detection and treatment of neonates with congenital hypothyroidism, a public health mandate should be to develop similar programs for the 75% of babies worldwide who are born in areas without newborn screening programs.<\/jats:p>","DOI":"10.1210\/jc.2011-1175","type":"journal-article","created":{"date-parts":[[2011,10,6]],"date-time":"2011-10-06T02:23:31Z","timestamp":1317867811000},"page":"2959-2967","source":"Crossref","is-referenced-by-count":146,"title":["Approach to the Diagnosis and Treatment of Neonatal Hypothyroidism"],"prefix":"10.1210","volume":"96","author":[{"given":"Stephen H.","family":"LaFranchi","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Oregon Health & Science University, Portland, Oregon 97239-3098"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","reference":[{"key":"2020071616134697200_B1","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1515\/JPEM.2007.20.5.559","article-title":"How should we be treating children with congenital hypothyroidism?","volume":"20","author":"LaFranchi","year":"2007","journal-title":"J Pediatr Endocrinol Metab"},{"key":"2020071616134697200_B2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1056\/NEJM198907063210103","article-title":"Maternal-fetal transfer of thyroxine in congenital hypothyroidism due to a total organification defect or thyroid agenesis.","volume":"321","author":"Vulsma","year":"1989","journal-title":"N Engl J Med"},{"key":"2020071616134697200_B3","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1016\/S0022-3476(75)80349-0","article-title":"Preliminary report on a mass screening program for neonatal hypothyroidism.","volume":"86","author":"Dussault","year":"1975","journal-title":"J Pediatr"},{"key":"2020071616134697200_B4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1651-2227.1978.tb16268.x","article-title":"Congenital hypothyroidism in Sweden. Incidence and age at diagnosis.","volume":"67","author":"Alm","year":"1978","journal-title":"Acta Paediatr Scand"},{"key":"2020071616134697200_B5","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.ymgme.2007.03.012","article-title":"Increase in congenital hypothyroidism in New York State and in the United States.","volume":"91","author":"Harris","year":"2007","journal-title":"Mol Genet Metab"},{"key":"2020071616134697200_B6","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1111\/j.1365-2265.2009.03568.x","article-title":"A 7-year experience with low blood TSH cutoff levels for neonatal screening reveals an unsuspected frequency of congenital hypothyroidism (CH).","volume":"71","author":"Corbetta","year":"2009","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2020071616134697200_B7","doi-asserted-by":"crossref","first-page":"S37","DOI":"10.1542\/peds.2009-1975D","article-title":"Trends in incidence rates of congenital hypothyroidism related to select demographic factors: data from the United States, California, Massachusetts, New York, and Texas.","volume":"125","author":"Hinton","year":"2010","journal-title":"Pediatrics"},{"key":"2020071616134697200_B8","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1530\/EJE-06-0709","article-title":"Screening for mutations in transcription factors in a Czech cohort of 170 patients with congenital and early-onset hypothyroidism: identification of a novel PAX8 mutation in dominantly inherited early-onset non-autoimmune hypothyroidism.","volume":"156","author":"Al Taji","year":"2007","journal-title":"Eur J Endocrinol"},{"key":"2020071616134697200_B9","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/S0022-3476(86)80276-1","article-title":"Detection of congenital hypopituitary hypothyroidism: ten-year experience in the Northwest Regional Screening Program.","volume":"109","author":"Hanna","year":"1986","journal-title":"J Pediatr"},{"key":"2020071616134697200_B10","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/1750-1172-5-17","article-title":"Congenital hypothyroidism.","volume":"5","author":"Rastogi","year":"2010","journal-title":"Orphanet J Rare Dis"},{"key":"2020071616134697200_B11","doi-asserted-by":"crossref","first-page":"S225","DOI":"10.1007\/s10545-010-9062-1","article-title":"Newborn screening strategies for congenital hypothyroidism: an update.","volume":"33","author":"LaFranchi","year":"2010","journal-title":"J Inherit Metab Dis"},{"key":"2020071616134697200_B12","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1515\/CCLM.2001.158","article-title":"Reference intervals from birth to adulthood for serum thyroxine (T4), triiodothryonine (T3), free T3, free T4, thyroxine binding globulin (TBG), and thyrotropin (TSH).","volume":"39","author":"Elmlinger","year":"2001","journal-title":"Clin Chem Lab Med"},{"key":"2020071616134697200_B13","doi-asserted-by":"crossref","first-page":"5145","DOI":"10.1210\/jc.2003-030743","article-title":"Color Doppler ultrasonography: diagnosis of ectopic thyroid gland in patients with congenital hypothyroidism caused by thyroid dysgenesis.","volume":"88","author":"Ohnishi","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616134697200_B14","first-page":"557","article-title":"A population-based study on the frequency of additional congenital malformations in infants with congenital hypothyroidism: data from the Italian Registry for Congenital Hypothyroidism (1991\u20131998).","volume":"87","author":"Olivieri","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071616134697200_B15","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/S0022-3476(72)80542-0","article-title":"Improved prognosis in congenital hypothyroidism treated before age three months.","volume":"81","author":"Klein","year":"1972","journal-title":"J Pediatr"},{"key":"2020071616134697200_B16","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1542\/peds.111.5.1055","article-title":"Treatment for congenital hypothyroidism: thyroxine alone or thyroxine plus triiodothyronine?","volume":"111","author":"Cassio","year":"2003","journal-title":"Pediatrics"},{"key":"2020071616134697200_B17","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1515\/JPEM.2004.17.7.967","article-title":"The use of L-T4 as liquid solution improves the practicability and individualized dosage in newborns and infants with congenital hypothyroidism.","volume":"17","author":"von Heppe","year":"2004","journal-title":"J Pediatr Endocrinol Metab"},{"key":"2020071616134697200_B18","doi-asserted-by":"crossref","first-page":"2290","DOI":"10.1542\/peds.2006-0915","article-title":"Update of newborn screening and therapy for congenital hypothyroidism.","volume":"117","author":"American Academy of Pediatrics","year":"2006","journal-title":"Pediatrics"},{"key":"2020071616134697200_B19","first-page":"49","article-title":"Revised guidelines for neonatal screening programmes for primary congenital hypothyroidism.","volume":"52","author":"European Society for Pediatric Endocrinology","year":"1999","journal-title":"Horm Res"},{"key":"2020071616134697200_B20","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1067\/mpd.2002.128887","article-title":"Initial treatment dose of L-thyroxine in congenital hypothyroidism.","volume":"141","author":"Selva","year":"2002","journal-title":"J Pediatr"},{"key":"2020071616134697200_B21","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/j.jpeds.2005.07.024","article-title":"Neurodevelopmental outcomes in congenital hypothyroidism: comparison of initial T4 dose and time to reach target T4 and TSH.","volume":"147","author":"Selva","year":"2005","journal-title":"J Pediatr"},{"key":"2020071616134697200_B22","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/j.1365-2265.2008.03172.x","article-title":"A novel therapeutic paradigm to treat congenital hypothyroidism.","volume":"69","author":"Mathai","year":"2008","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2020071616134697200_B23","doi-asserted-by":"crossref","first-page":"13.e1","DOI":"10.1016\/j.jpeds.2010.05.025","article-title":"Food and levothyroxine administration in infants and children.","volume":"157","author":"Zeitler","year":"2010","journal-title":"J Pediatr"},{"key":"2020071616134697200_B24","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/S0022-3476(84)80543-0","article-title":"Characteristics of infantile hypothyroidism discovered on neonatal screening.","volume":"104","author":"New England Congenital Hypothyroidism Collaborative","year":"1984","journal-title":"J Pediatr"},{"key":"2020071616134697200_B25","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1515\/JPEM.1996.9.1.63","article-title":"Thyroid hormone and attention in congenital hypothyroidism.","volume":"9","author":"Rovet","year":"1996","journal-title":"J Pediatr Endocrinol Metab"},{"key":"2020071616134697200_B26","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1542\/peds.76.5.734","article-title":"Screening for congenital hypothyroidism with specimen collection at two time periods: results of the Northwest Regional Screening Program.","volume":"76","author":"LaFranchi","year":"1985","journal-title":"Pediatrics"},{"key":"2020071616134697200_B27","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1515\/JPEM.2006.19.1.31","article-title":"Congenital hypothyroidism and the second newborn metabolic screening in Colorado, USA.","volume":"19","author":"Maniatis","year":"2006","journal-title":"J Pediatr Endocrinol Metab"},{"key":"2020071616134697200_B28","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1089\/10507250050137770","article-title":"Atypical hypothyroidism and the very low birthweight infant.","volume":"10","author":"Mandel","year":"2000","journal-title":"Thyroid"},{"key":"2020071616134697200_B29","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.jpeds.2010.10.018","article-title":"Congenital hypothyroidism with a delayed thyroid-stimulating hormone (TSH) elevation in very premature infants: incidence and growth and developmental outcomes.","volume":"158","author":"Woo","year":"2011","journal-title":"J Pediatr"},{"key":"2020071616134697200_B30","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1136\/adc.2010.190280","article-title":"Prevention of intellectual disability through screening for congenital hypothyroidism: how much and at what level?","volume":"96","author":"Grosse","year":"2011","journal-title":"Arch Dis Child"},{"key":"2020071616134697200_B31","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.1542\/peds.2009-1975C","article-title":"Prevalence of congenital hypothyroidism\u2014current trends and future directions: workshop summary.","volume":"125","author":"Olney","year":"2010","journal-title":"Pediatrics"},{"key":"2020071616134697200_B32","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1089\/thy.2007.0107","article-title":"Environmental chemicals impacting the thyroid: targets and consequences.","volume":"17","author":"Zoeller","year":"2007","journal-title":"Thyroid"},{"key":"2020071616134697200_B33","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1159\/000106818","article-title":"Possible non-Mendelian mechanisms of thyroid dysgenesis.","volume":"10","author":"Delado\u00eby","year":"2007","journal-title":"Endocr Dev"},{"key":"2020071616134697200_B34","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/j.jpeds.2010.10.006","article-title":"Clinical monitoring guidelines for congenital hypothyroidism: laboratory outcome data in the first year of life.","volume":"158","author":"Balhara","year":"2011","journal-title":"J Pediatr"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/96\/10\/2959\/9109855\/jcem2959.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/96\/10\/2959\/9109855\/jcem2959.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T04:25:07Z","timestamp":1686371107000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/96\/10\/2959\/2834823"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,10,1]]},"references-count":34,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2011,10,1]]}},"URL":"https:\/\/doi.org\/10.1210\/jc.2011-1175","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,10,1]]}}}