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Updated: Jun 27, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neonatal thyroxine, maternal thyroid function, and child cognition
Emily Oken1, Lewis E Braverman, Deborah Platek
1Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, Massachusetts 02215, USA. emily_oken@hphc.org
Insights
Newborn thyroid hormone (T4) levels within the normal range do not predict cognitive development in children. This study found no association between neonatal T4 and later cognitive test scores in an iodine-sufficient area.
Area of Science:
- Endocrinology
- Neuroscience
- Developmental Pediatrics
Background:
- Thyroid hormone is crucial for brain development.
- Limited data exist on neonatal thyroid function's impact on later cognitive outcomes.
Purpose of the Study:
- To investigate associations between newborn thyroxine (T4) levels and maternal thyroid function.
- To examine the relationship between newborn T4 levels and childhood cognitive development.
Main Methods:
- A cohort study of 500 children born between 1999-2003.
- Cognitive test scores were assessed at 6 months and 3 years of age.
- Newborn T4 levels and maternal thyroid function (T4, TSH, thyroid peroxidase antibodies) were measured.
Main Results:
- Higher newborn T4 levels were unexpectedly linked to poorer visual recognition memory scores at 6 months.
- No significant associations were found between newborn T4 and cognitive scores at 3 years.
- Maternal thyroid function tests were not associated with child cognitive outcomes.
Conclusions:
- Newborn T4 concentrations within the normal physiological range do not predict cognitive outcomes.
- Neonatal thyroid function is not associated with maternal thyroid function in this population.
- Findings are relevant for iodine-sufficient regions.
Context:
Thyroid hormone is essential for normal brain development. Limited data are available regarding whether thyroid function in neonates influences later cognitive development.
Objective:
Our objective was to study associations of newborn T4 levels with maternal thyroid function and childhood cognition.
Design And Setting:
We studied participants in Project Viva, a cohort study in Massachusetts.
Participants:
We studied a total of 500 children born 1999--2003 at 34 wk or more.
Main Outcome Measures:
We determined cognitive test scores at ages 6 months and 3 yr.
Results:
Mean newborn T4 at a mean age of 1.94 d was 17.6 (sd 4.0) microg/dl, and levels were higher in girls [1.07 microg/dl; 95% confidence interval (CI) 0.38, 1.76] and infants born after longer gestation (0.42 microg/dl; 95% CI 0.17, 0.67 per wk). Newborn T4 levels were not associated with maternal T4, TSH, or thyroid peroxidase antibody levels. On multivariable linear regression analysis, adjusting for maternal and child characteristics, higher newborn T4 was unexpectedly associated with poorer scores on the visual recognition memory test among infants at age 6 months (-0.5; 95% CI -0.9, -0.2), but not with scores at age 3 yr on either the Peabody Picture Vocabulary Test (0.2; 95% CI -0.1, 0.5) or the Wide Range Assessment of Visual Motor Abilities (0.1; 95% CI -0.2, 0.3). Maternal thyroid function test results were not associated with child cognitive test scores.
Conclusions:
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.
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