Neonatal Thyroxine, Maternal Thyroid Function, and Child Cognition

Oken, Emily; Braverman, Lewis E.; Platek, Deborah; Mitchell, Marvin L.; Lee, Stephanie L.; Pearce, Elizabeth N.

doi:10.1210/jc.2008-0936

Cited by 120 publications

(104 citation statements)

References 37 publications

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“…perceptual performance MSCA outcomes (44), consistent with the present findings. By contrast, other authors reported that higher newborn T 4 was unexpectedly associated with lower scores on the visual recognition memory test at the age of 6 months but not with scores for verbal abilities, intelligence or visual motor abilities at the age of 3 years (45). Another study observed no neurological impairment in infants aged !1 year born to mothers with elevated TSH during pregnancy (46).…”

Section: Discussionmentioning

confidence: 85%

Newborn TSH concentration and its association with cognitive development in healthy boys

Freire

Ramos²,

Amaya³

et al. 2010

European Journal of Endocrinology

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Objective: An association between thyroid function during pregnancy or infancy and neurodevelopment in children has been demonstrated. We aimed to investigate whether newborn TSH concentrations are related to subsequent neurocognitive development. Design: We conducted a longitudinal study on 178 children from a general population birth cohort in Granada (Spain) born in [2000][2001][2002]. Methods: TSH concentrations were measured in umbilical cord blood, and cognitive functions were assessed at 4 years of age using the McCarthy's scales of children's abilities (MSCA). Organochlorine (OC) compound concentrations and the combined oestrogenicity (total effective xeno-oestrogenic burden (TEXB)) were also determined in the placentae. Results: Mean newborn TSH was 3.55 mU/l (rangeZ0.24-17 mU/l). In multivariate regression analyses, adjusting for maternal and child characteristics, higher newborn TSH concentrations showed a decrease of 3.51 and 3.15 points on the MSCA general cognitive and executive function scores respectively and were associated with a higher risk of scoring below the 20th percentile (P20) on the quantitative score (odds ratio (OR)Z2.64). Children with TSH in the upper quartile (4.19-17.0 mU/l) were at higher risk of scoring !P20 on span memory (ORZ5.73), whereas children with TSH in the second quartile (2.05-2.95 mU/l) were at lower risk of scoring !P20 on the verbal scale (ORZ0.24). Neonatal TSH status was also associated with general cognitive and executive function outcomes when controlling for prenatal exposure to OCs or placental TEXB. Conclusions: Newborn thyroid hormone status expressed by TSH in cord blood may adversely affect later cognitive function. A more thorough screening for neonatal thyroid deficiency is warranted.

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Section: Discussionmentioning

confidence: 85%

Newborn TSH concentration and its association with cognitive development in healthy boys

Freire

Ramos²,

Amaya³

et al. 2010

European Journal of Endocrinology

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“…By contrast, one study did not find any relationship between maternal T4 levels and cognitive development in children at 6 months (visual recognition memory) and 3 years of age (PPVT and Wide Range of Visual Motor Ability). However, this study included only a very small number of women with abnormal thyroid function (Oken et al, 2009). Berbel et al (2009 carried out a trial in Spain that showed better gross and fine motor coordination and socialization (Brunet-Lezine Scale) in 18-month-old children whose mothers were supplemented with iodine from early pregnancy, compared to those who took the supplement from late pregnancy.…”

Section: Iodinementioning

confidence: 99%

The Role of Nutrition in Children's Neurocognitive Development, From Pregnancy Through Childhood

Nyaradi¹,

Li²,

Hickling³

et al. 2015

Prenatal and Childhood Nutrition

129

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This review examines the current evidence for a possible connection between nutritional intake (including micronutrients and whole diet) and neurocognitive development in childhood. Earlier studies which have investigated the association between nutrition and cognitive development have focused on individual micronutrients, including omega-3 fatty acids, vitamin B12, folic acid, choline, iron, iodine, and zinc, and single aspects of diet. The research evidence from observational studies suggests that micronutrients may play an important role in the cognitive development of children. However, the results of intervention trials utilizing single micronutrients are inconclusive. More generally, there is evidence that malnutrition can impair cognitive development, whilst breastfeeding appears to be beneficial for cognition. Eating breakfast is also beneficial for cognition. In contrast, there is currently inconclusive evidence regarding the association between obesity and cognition. Since individuals consume combinations of foods, more recently researchers have become interested in the cognitive impact of diet as a composite measure. Only a few studies to date have investigated the associations between dietary patterns and cognitive development. In future research, more well designed intervention trials are needed, with special consideration given to the interactive effects of nutrients.

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“…A growing body of evidence indicates that developmental delay even occurs in children whose mothers had thyroxine (T 4 ) levels that were slightly lower (but still within the normal range) early in pregnancy (4,5,6,7,8), although some studies were negative (9,10). However, participants in these studies were followed until the age of 3 using developmental tests like the Bayley Scales of Infant Development (version II), which have a poor prognostic value for future cognitive impairments (11,12).…”

Section: Introductionmentioning

confidence: 99%

Maternal hypothyroxinaemia in early pregnancy and school performance in 5-year-old offspring

Noten

Loomans

Vrijkotte

et al. 2015

European Journal of Endocrinology

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Objective: Overt hypothyroidism in pregnant women is associated with a lower intelligence quotient in their children. More recently, subtle decreases in maternal thyroid function have also been associated with neurodevelopmental impairment in offspring. We tested the effect of hypothyroxinaemia during early pregnancy on school performance. Design: This was a longitudinal study that included the data of 1196 mother-child pairs from the Amsterdam Born Children and Their Development study. Methods: Maternal serum free thyroxine (T 4 ) and TSH were obtained at a median gestational age of 12.9 (interquartile range: 11.9-14.3) weeks. School performance was assessed at age 5 years and based on scores obtained in arithmetic and language tests from the national monitoring and evaluation system. Poor school performance was defined as a test result !25th percentile and subnormal school performance as a result !50th percentile of the norm population. To estimate the impact of possible non-response bias, we conducted inverse-probability weighted analyses. Results: Maternal hypothyroxinaemia (i.e., a maternal free T 4 in the lowest 10% of distribution) was associated with a 1.61 (95% CI: 1.05-2.47) -fold increased odds of subnormal arithmetic performance after adjustment for confounders (PZ0.03). However, the odds ratio dropped to 1.48 (95% CI: 0.94-2.32) after inverse-probability weighting (PZ0.09). No such relations were found with TSH. Conclusions: Maternal hypothyroxinaemia at the end of the first trimester was associated with reduced performance in an arithmetic test, but not in a language test, in 5-year-old offspring. However, our results should be interpreted carefully because of possible non-response bias.

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Neonatal Thyroxine, Maternal Thyroid Function, and Child Cognition

Abstract: Newborn T4 concentrations within a normal physiological reference range are not associated with maternal thyroid function and do not predict cognitive outcome in a population living in an iodine-sufficient area.

Cited by 120 publications

References 37 publications

Newborn TSH concentration and its association with cognitive development in healthy boys

Newborn TSH concentration and its association with cognitive development in healthy boys

The Role of Nutrition in Children's Neurocognitive Development, From Pregnancy Through Childhood

Maternal hypothyroxinaemia in early pregnancy and school performance in 5-year-old offspring

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