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Thyroid hormone is essential to growth and neurologic development in childhood. The thyroid begins to take shape at 7 weeks’ gestation, and thyroid hormone (T4, thyroxine) is produced starting at 12 weeks’ gestation. Thyroid dysfunction in the neonate, infant, or child has a significant impact on development. The goal of treatment is to assure normal growth and avoid developmental delay.

Neonatal hypothyroidism results from decreased T4 production in a newborn. It is the most preventable cause of potential intellectual disability. T4 is critical to the myelinization of the central nervous system (CNS) during the first 3 years after birth. In the healthy term baby, serum thyroid-stimulating hormone (TSH) concentrations normally rise abruptly to 60 to 80 mU/L within 30 to 60 minutes after delivery. The serum TSH concentration then decreases rapidly to about 20 mU/L by 1 day of age and...

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