Details:

Alternative Title:
BMC Pediatr
Personal Author:
Kemper, Alex R. ; Ouyang, Lijing ; Grosse, Scott D.
Kemper, Alex R. ; Ouyang, Lijing ; Grosse, Scott D. Less -
Description:
Background

Thyroid hormone treatment in children with congenital hypothyroidism can prevent intellectual disability. Guidelines recommend that children diagnosed with congenital hypothyroidism through newborn screening remain on treatment to at least 3 years of age, after which a trial off therapy can determine which children have transient hypothyroidism. The purpose of this study was to describe the rate at which children with congenital hypothyroidism in the United States discontinue thyroid hormone treatment in early childhood.

Methods

Retrospective analysis of the 2002-2006 MarketScan® Commercial Claims and Encounters research databases and the 2001-2005 MarketScan Multi-State Medicaid databases. Children were classified as having congenital hypothyroidism based on billing codes and having filled a prescription for thyroid hormone treatment. Kaplan-Meier curve analysis was used to determine discontinuation rates.

Results

There were a total of 412 Medicaid-enrolled children and 292 privately-insured children with presumed congenital hypothyroidism included in this study. The overall birth prevalence of congenital hypothyroidism across both datasets was about 1 per 2,300. By 36 months, the percentage who had discontinued thyroid replacement treatment was 38% (95% Confidence Interval: 32%-44%). Medicaid-enrolled children had a more rapid decline in the first 24 months of treatment compared to those with private insurance (P = 0.02).

Conclusions

More than one-third of children treated for congenital hypothyroidism discontinued treatment within 36 months, which is inconsistent with current guidelines. It is not known how many of these children required continued treatment or experience adverse effects from discontinuation. These findings emphasize the critical need for follow-up systems to monitor the outcome of newborn screening.


Subjects:
[+]
Age Factors Congenital Hypothyroidism Databases, Factual Drug Utilization Female Guideline Adherence Humans Infant Infant, Newborn Insurance, Health Insurance Carriers Male Medicaid Neonatal Screening Practice Guidelines As Topic Prevalence Remission, Spontaneous Thyroid Hormones Withholding Treatment
Source:
BMC Pediatr. 2010; 10:9.
Document Type:
Journal Article
Place as Subject:
United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:ab82c6b8c08919895a63267e1a5ba4f18fecc61356b7316bea0ccf7c288eabcf
Download URL:
https://stacks.cdc.gov/view/cdc/3418/cdc_3418_DS1.pdf
File Type:

Supporting Files

• 	1471-2431-10-9-1.gif	gif
  	1471-2431-10-9-1.jpg	jpeg
  	1471-2431-10-9.nxml	txt
  	license.txt	txt

More +