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Centre for International Child Health, Institute of Child Health, London WC1N 1EH, UK and * Institute of Nutrition and Food Science, University of Dhaka, Dhaka 1000, Bangladesh
3To whom correspondence should be addressed.
Iodine deficiency in pregnancy leads to poor cognitive function in the
offspring; however, the effect of concurrent iodine deficiency on
school-aged children is not clear. Several studies have shown that
school children in iodine-deficient villages have poorer cognitive
function than children in iodine-sufficient villages. However,
villages differ in many factors that may also detrimentally affect
children's development. In addition, the children's nutritional and
health status has not usually been taken into account. In this study,
we compared the cognitive function and school achievement levels of 170
children who had recently had low thyroxine (T4) levels
[T4 
45 nmol/L (hypothyroid)] with children who had not
had low T4 levels [T4 
70 nmol/L
(euthyroid)]. The children were matched for school and grade level and
came from the same iodine-deficient regions in rural Bangladesh.
They were given a battery of cognitive, motor and school achievement
tests. We also measured their nutritional status, examined their stools
for geohelminths and assessed their home environments. A factor
analysis of cognitive and motor function tests yielded two factors, a
general cognitive factor and a fine motor factor. The children's
height and arm circumference, experience of hunger, parental
characteristics and stimulation in the home made independent
contributions to their test scores. Controlling for these variables,
the hypothyroid children performed worse than the euthyroid children on
reading and spelling and the general cognitive factor. These findings
indicate that a large number of disadvantages including hypothyroidism
are related to the poor development of these children.
KEY WORDS: • iodine deficiency • academic achievement • cognitive function • school children
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