Association of maternal thyroid function with birthweight: a systematic review and individual-participant data meta-analysis

Derakhshan, Arash; Peeters, Robin P.; Taylor, Peter; Bliddal, Sofie; Carty, David; Meems, Margreet; Vaidya, Bijay; Chen, Liangmiao; Knight, Bridget; Ghafoor, Farkhanda; Popova, Polina; Mosso, Lorena; Oken, Emily; Suvanto, Eila; Hisada, Aya; Yoshinaga, Jun; Brown, Suzanne J.; Bassols, Judit; Auvinen, Juha; Bramer, Wichor M.; López‐Bermejo, Abel; Dayan, Colin; French, Robert; Boucai, Laura; Vafeiadi, Marina; Grineva, Elena; Pop, Victor J M; Vrijkotte, Tanja G. M.; Chatzi, Leda; Sunyer, Jordi; Jiménez-Zabala, Ana; Riaño, Isolina; Rebagliato, Marisa; Lu, Xuemian; Pirzada, Amna; Männistö, Tuija; Delles, Christian; Feldt‐Rasmussen, Ulla; Alexander, Erik K.; Nelson, Scott M.; Chaker, Layal; Pearce, Elizabeth N.; Guxens, Mònica; Steegers, Eric A.P.; Walsh, John P.; Korevaar, Tim I M

doi:10.1016/s2213-8587(20)30061-9

Cited by 136 publications

(85 citation statements)

References 59 publications

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“…Both overt and subclinical hypothyroidism poses a risk of placental abruption, preterm delivery, and LBW [21,22] However, the risk for LBW deliveries is lower in mothers suffering from subclinical hypothyroidism as compared to those affected with overt hypothyroidism [23,24]. This has been confirmed by a study by Blazer et al [25] stating that the women affected with hypothyroidism gave birth to LBW infants [25].…”

Section: Discussionmentioning

confidence: 87%

Association between Maternal Thyroid Hormone Level and Fetal Weight

Mueed

Kumar

Jain

et al. 2021

JPRI

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Aims: Present study is aimed to find out the association between maternal thyroid hormone at delivery and weight of delivered fetus. Study Design: This is a case-control study in which low birth weight was cases and appropriate for gestational age were considered as control. Place and Duration of Study: Study was conducted at National Institute of Pathology (ICMR), New Delhi and Department of Biotechnology, Invertis University, Bareilly from July 2018 to July 2020. Subjects and Methods: A total of 193 maternal blood samples were collected and fetal parameters were recorded as per inclusion criteria. Quantitative estimation of Triiodothyronine (T3), Thyroxine (T4), and Thyroid Stimulating Hormone (TSH) was done in the separated serum samples by pre-coated ELISA kits and data analysis was performed using SigmaStat. Cases include women having full-term deliveries with birth weight < 2.5Kg i.e. Low Birth Weight (LBW) and Controls includes women having Appropriate for Gestational Age (AGA) delivery with birth weight > 2.5Kg. Results: No significant difference was observed in maternal age as well as age at marriage and other demographic parameters, while maternal weight and BMI is significantly less in LBW as compared to AGA i.e. 49.62±5.34 & 53.96±6.92 and 21.32±4.01 and 22.66±1.57 respectively having P<0.001. Pearson correlation coefficient also revealed a significant negative correlation of T4 with both fetal weight and fetal length and a positive correlation of T3 with fetal weight, fetal length, and fetal head circumference, whereas TSH did not show any significant association with fetal parameters. Conclusion: It was concluded that maternal T3 and T4 affects the fetal development during gestational period, TSH did not show any significant association with fetal parameters.

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Section: Discussionmentioning

confidence: 87%

Association between Maternal Thyroid Hormone Level and Fetal Weight

Mueed

Kumar

Jain

et al. 2021

JPRI

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“…Leon et al [ 56 ] observed that maternal TSH during the first half of pregnancy were inversely related to birth weight and a higher risk of small-for-gestational-age (SGA) newborns. Likewise, a meta-analysis [ 57 ] found significance between maternal subclinical hypothyroidism with a lower mean birth weight than euthyroidism. They also found that isolated hypothyroxinemia was associated with a lower risk of SGA than euthyroidism and a higher mean weight at birth.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Thyroid Status during the First Trimester of Pregnancy and Neonatal Well-Being

2021

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Iodine is an essential micronutrient for the synthesis of thyroid hormones. The proper functioning of the thyroid axis is essential for the normal development of the nervous system, especially in the first trimester of gestation. The aim of the present study was to analyze the perinatal outcomes, anthropometry, and APGAR test scores of newborns and to relate them to maternal thyroid status. A total of 190 newborns participated in the study. No correlation was found between thyroid stimulating hormone (TSH) and maternal ioduria values in the first trimester of gestation with the weight or length of the newborn, or the APGAR score at one minute after birth. However, we found significant differences between the APGAR scores of children whose mothers had an iodine sufficiency level in the first trimester compared to the children of mothers with iodine deficiency. Similarly, the APGAR scores of children whose mothers had a TSH > 4 have significantly better APGAR scores than the children of mothers with a TSH < 4. Likewise, we found significant differences between the measurements of the newborns depending on whether their mothers smoked. The children of mothers who took iodine supplements or iodized salt obtained the highest APGAR score at one and five minutes after birth. It is essential to focus on recommending adequate consumption of iodine supplements and iodized salt prior to gestation and at least during the first trimester to achieve better fetal well-being.

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“…Previous effect estimates for the maternal-fetal relationship still warranted replications in large well-designed cohorts. Another recent meta-analysis ( 29 ) aggregated individual-level data of 48,145 mother–child pairs from 20 observational cohorts and detected an inverse association between maternal TSH and FT4 within the normal range and birth weight. Specifically, each 1 SD higher maternal TSH and FT4 was associated with 6 g lower (95%CI, −10 to −2; P = 0.003) and 21 g lower (95%CI, −25 to −17; P < 0.0001) birth weight, respectively.…”

Section: Discussionmentioning

confidence: 99%

Does Maternal Normal Range Thyroid Function Play a Role in Offspring Birth Weight? Evidence From a Mendelian Randomization Analysis

Zhang

Chen

et al. 2020

Front. Endocrinol.

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Background The association between normal range thyroid function and offspring birth weight has been postulated, but evidence from observational studies is prone to be confounded. We conducted a two-sample Mendelian randomization (MR) study to explore the causal effects of maternal thyroid stimulating hormone (TSH) and free thyroxine (FT4) on birth weight. Methods We utilized public shared summary-level statistics from European-ancestry genome wide association studies. We obtained 40 and 21 single nucleotide polymorphisms as instrumental variables, which were associated with TSH and FT4 levels at genome-wide significance ( P < 5 × 10 −8 ). Partitioned maternal effects on birth weight were retrieved from datasets contributed by the Early Growth Genetics Consortium. Inverse-variance weighted method was employed in the primary MR analysis and multiple sensitivity analyses were implemented. Results Genetically determined normal range thyroid function was not causally associated with offspring birth weight. Each one standard deviation (SD) increase in maternal TSH was associated with 0.002 SD higher of birth weight (95% confidence interval [CI], −0.021 to 0.025; P = 0.87). Similarly, change in birth weight was −0.001 SD (95% CI, −0.031 to 0.029; P = 0.94) per one SD higher in maternal FT4. Consistent results were yielded via additional MR methods. Sensitivity analyses demonstrated no presence of horizontal pleiotropy or heterogeneity. Conclusion This MR study did not identify a causality between normal range thyroid function and offspring birth weight in the Europeans.

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Association of maternal thyroid function with birthweight: a systematic review and individual-participant data meta-analysis

Cited by 136 publications

References 59 publications

Association between Maternal Thyroid Hormone Level and Fetal Weight

Association between Maternal Thyroid Hormone Level and Fetal Weight

Relationship between Thyroid Status during the First Trimester of Pregnancy and Neonatal Well-Being

Does Maternal Normal Range Thyroid Function Play a Role in Offspring Birth Weight? Evidence From a Mendelian Randomization Analysis

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