Bibliometric analysis of research on pediatric hypothyroidism treatment: a global perspective on trends and emerging fronts (2018-2026).

BACKGROUND: Pediatric hypothyroidism is among the most prevalent endocrine disorders in childhood, yet no bibliometric analysis has systematically mapped the research landscape of its treatment. OBJECTIVE: This study aimed to characterize the publication trends, geographic distribution, research hotspots, and emerging fronts in pediatric hypothyroidism treatment research from 2018 to 2026. METHODS: A comprehensive search was conducted in the Web of Science Core Collection (WoSCC) as the primary database, with external data validation performed via PubMed. Bibliometric indicators were analyzed using CiteSpace, Python and R. Keyword co-occurrence networks were constructed with Louvain community detection, and burst detection was performed to identify emerging research fronts. RESULTS: A total of 1,302 publications were included. Annual output grew from 138 (2018) to a peak of 183 (2022). The United States (n = 263, 20.2%), China (n = 203, 15.6%), and Italy (n = 137, 10.5%) were the leading contributors. Five thematic clusters were identified: (1) congenital hypothyroidism and neonatal screening; (2) subclinical hypothyroidism; (3) pregnancy-related thyroid disorders; (4) autoimmune thyroid disease; and (5) comorbidities and genetic syndromes. Burst detection revealed "obesity" (burst strength = 7.2), "COVID-19" (4.0), and "thyroid dyshormonogenesis" (3.2) as emerging fronts. CONCLUSIONS: The field is shifting focus from congenital hypothyroidism screening optimization toward subclinical hypothyroidism management and the recognition of obesity-related TSH elevation as a distinct physiological entity. Future research should prioritize prospective trials on watchful-waiting strategies and obesity-specific TSH reference ranges.