Comorbidity in Congenital Hypothyroidism-A Nationwide, Population-based Cohort Study

Context Patients with congenital hypothyroidism (CH) are affected more often than the general population by other chronic diseases and neurological difficulties. Objective The aim of this nationwide population-based register study was to investigate the incidence of congenital malformations, comorbidities, and the use of prescribed drugs in patients with primary CH. Methods The study cohort and matched controls were identified from national population-based registers in Finland. All diagnoses from birth until the end of 2018 were collected from the Care Register, and subject-specific prescription drug purchases were identified from The Prescription Register from birth until the end of 2017. Results Diagnoses of neonatal and chronic diseases were collected for 438 full-term patients and 835 controls (median follow-up time 11.6 years; range, 0-23 years). Newborns with CH were more often found to have neonatal jaundice (11.2% and 2.0%; P < .001), hypoglycemia (8.9% and 2.8%; P < .001), metabolic acidemia (3.2% and 1.1%; P = .007), and respiratory distress (3.9% and 1.3%; P < .003) as compared to their matched controls. Congenital malformations were diagnosed in 66 of 438 (15.1%) CH patients and in 62 of 835 (7.4%) controls (P < .001). The most commonly affected extrathyroidal systems were the circulatory and musculoskeletal systems. The cumulative incidence of hearing loss and specific developmental disorders was higher among CH patients than controls. The use of antidepressant and antipsychotic drugs was similar in CH patients and their controls. Conclusion CH patients have more neonatal morbidity and congenital malformations than their matched controls. The cumulative incidence of neurological disorders is higher in CH patients. However, our results do not support the existence of severe psychiatric comorbidity.

Automated summary

This nationwide population-based register study found that patients with congenital hypothyroidism (CH) are more susceptible to other chronic diseases and neurological difficulties than the general population. The study also revealed a higher incidence of congenital malformations in CH patients. Additionally, CH patients had a higher cumulative incidence of hearing loss and specific developmental disorders, but there was no significant difference in severe psychiatric comorbidity compared to the control group.