Abnormalities of maternal thyroid function during pregnancy affect neuropsychological development of their children at 25–30 months

Li, Yuanbin; Shan, Zhongyan; Wang, Teng; Yu, Xiao‐Juan; Li, Yushu; Fan, Chenling; Teng, Xiaochun; Guo, Rui; Wang, Hong; Li, Jia; Chen, Yanyan; Wang, Weiwei; Chawinga, Masauso; Zhang, Li; Liu, Yang; Zhao, Yaru; Hua, Tianyi

doi:10.1111/j.1365-2265.2009.03743.x

Cited by 360 publications

(267 citation statements)

References 18 publications

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“…This mechanism, however, is speculative and should be tested by animal or imaging studies. Moreover, our negative findings are not consistent with previous studies of thyroid antibodies and child intelligence (16,17). While our negative results are based on parent report of cognition, the other studies used observational measurements of cognition that are not feasible in large population-based studies.…”

Section: Discussioncontrasting

confidence: 56%

“…This led us to explore whether elevated titers of TPOAbs in pregnant women underlie the relation of maternal thyroid dysfunction with the offspring's cognitive and behavioral development. Few studies address the role of maternal TPOAbs during pregnancy and the association with cognitive functioning of the child (16,17). Within a sample of about 300 pregnant women, Pop et al reported that the children of TPOAb-positive women with normal thyroid status are at a risk of cognitive dysfunction (17).…”

mentioning

confidence: 99%

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Maternal Thyroid Autoimmunity During Pregnancy and the Risk of Attention Deficit/Hyperactivity Problems in Children: The Generation R Study

Ghassabian

Bongers-Schokking

Rijke

et al. 2012

Thyroid

127

106

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Background: Maternal thyroid status and autoimmunity during pregnancy have been associated with impaired development of the offspring in animal and human studies. Our objective was to examine whether elevated titers of maternal thyroid peroxidase antibodies (TPOAbs) in early pregnancy increased the risk of cognitive impairment and problem behavior in preschool children. Second, we aimed at exploring to what extent any effect on child behavior was mediated by maternal thyroid parameters during pregnancy. Methods: In the Generation R Study, a population-based cohort of 3139 children and their mothers, we measured maternal thyroid parameters (thyrotropin [TSH], free Thyroxine, and TPOAbs) at 13.5 -1.8 weeks of gestation. Children's verbal and nonverbal cognitive functioning was measured at 2.5 years using the Language Development Survey and the Parent Report of Children Abilities. At 3 years, children's behavior was assessed using the Child Behavior Checklist. Results: Elevated titers of TPOAbs during pregnancy did not predict the verbal and nonverbal cognitive functioning of the children. However, elevated titers of TPOAbs in mothers were associated with externalizing problems in children (odds ratio [OR] = 1.64, 95% confidence interval [CI]: 1.17-2.29, p = 0.004). In particular, children of TPOAb-positive mothers were at a higher risk of attention deficit/hyperactivity problems (OR = 1.77, 95% CI: 1.15-2.72, p = 0.01). To explore whether the effect of maternal TPOAbs on child problem behavior was mediated by maternal thyroid parameters, we added maternal TSH to the model. After correcting for TSH, the effect of TPOAbs on externalizing problems was attenuated slightly but remained significant (OR = 1.56, 95% CI: 1.14, 2.14, p = 0.005). Conclusions: Our findings imply that the elevated titers of TPOAbs during pregnancy impact children's risk of problem behavior, in particular, attention deficit/hyperactivity. The observed effect is only partially explained by maternal TSH levels. These findings may point to a specific mechanism of Attention Deficit/Hyperactivity Disorder in children. Nevertheless, we can only speculate about public health implication of the study, as there is no specific treatment for TPOAb-positive pregnant women with normal thyroid function. Further investigation is needed to explore whether TPOAb-positive pregnant women and their children can benefit from close monitoring and early detection of developmental delay in populations at risk.

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Section: Discussioncontrasting

confidence: 56%

mentioning

confidence: 99%

Maternal Thyroid Autoimmunity During Pregnancy and the Risk of Attention Deficit/Hyperactivity Problems in Children: The Generation R Study

Ghassabian

Bongers-Schokking

Rijke

et al. 2012

Thyroid

127

106

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“…Up until the 12th to the 14th week, the embryo depends completely on the mother ' s thyroxine; and is even still partially dependent on it, afterwards. Many papers have been published on the potential impact of subclinical hypothyroidism on both maternal and foetal health (63,68,69) . There is evidence that maternal thyroid hormones can cross the placenta, and act to modulate the foetal central nervous system ' s development prior to the foetuses ' own endogenous thyroid hormone secretion begin.…”

Section: Thyroid Diseases In Pregnancy -Possibilities For Screeningmentioning

confidence: 99%

Recommendations on prenatal screening and the connections to other diseases such as thyroid dysfunction

Springer

Potluková²,

Límanová³

et al. 2012

Clinical Chemistry and Laboratory Medicine (CCLM)

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The aim of general maternal-foetal care is to ensure an uncomplicated birth of a healthy baby to a healthy mother. There is a large range of screening tests used during pregnancy: for gestational diabetes, infection, rhesus-D status, thyroid dysfunction, as well as other tests. An important part of prenatal care is the screening of major aneuploidies, primarily for Down ' s syndrome. This screening is possible in either the fi rst or second trimester, or in both. Management of this type of screening is very similar around the world. Hypothyroidism can affect the psychomotor development of the child. Thyroidstimulating hormone (TSH), autoantibodies against thyroperoxidase (TPOAb), and free thyroxin (FT4) were determined within our group of 7530 pregnant women. Elevated concentrations of TSH were found in 5.1 % , suppression was found in 2.9 % and 11.5 % were TPOAb positive. Either a familial or personal history of thyroid or autoimmune diseases was present in 58.3 % of those women who tested positive on any thyroid test. At minimum, 40 % of women TPOAb positive during pregnancy have some kind of thyroid disorders after delivery. These results support the effi cacy of general thyroid function screening in early pregnancy, as well as the follow-up after delivery of those women who are positive.

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“…Moreover, the positivity for thyroid autoantibodies in euthyroid pregnant women affects neuropsychological development of the offspring per se [75] The reasons for the associations between anti-thyroid antibodies and obstetric complications remain unclear. They may be related to a direct effect of the anti-thyroid antibodies, or the anti-thyroid antibodies may serve as a marker for other causative autoimmune syndromes.…”

Section: Thyroid Auto-immunitymentioning

confidence: 99%

11 Hypothyroidism in Pregnancy

Lazarus¹,

Pīrāgs²,

Butz³

2009

The Thyroid and Reproduction

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Abnormalities of maternal thyroid function during pregnancy affect neuropsychological development of their children at 25–30 months

Cited by 360 publications

References 18 publications

Maternal Thyroid Autoimmunity During Pregnancy and the Risk of Attention Deficit/Hyperactivity Problems in Children: The Generation R Study

Maternal Thyroid Autoimmunity During Pregnancy and the Risk of Attention Deficit/Hyperactivity Problems in Children: The Generation R Study

Recommendations on prenatal screening and the connections to other diseases such as thyroid dysfunction

11 Hypothyroidism in Pregnancy

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