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Maternal hypothyroxinaemia in early pregnancy and problem behavior in 5-year-old offspring
Maurits H W Oostenbroek1, Remco H J Kersten1, Benjamin Tros1
1Department of Public Health, Academic Medical Centre, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands.
Insights
Maternal thyroid function in early pregnancy is linked to attention problems in children. Low thyroid hormone levels in mothers were associated with increased odds of hyperactivity and inattention in offspring, but not other behavioral issues.
Area of Science:
- Endocrinology
- Developmental Psychology
- Public Health
Background:
- Subtle maternal thyroid dysfunction in early pregnancy may pose risks to offspring cognitive development and attention.
- Previous research has not consistently addressed the link between maternal thyroid function and various problem behaviors in children.
Purpose of the Study:
- To investigate the association between maternal thyroid function in early pregnancy and diverse problem behaviors in offspring at 5-6 years of age.
- To determine if maternal thyroid hormone levels impact hyperactivity/inattention, conduct problems, emotional problems, peer issues, and prosocial behavior.
Main Methods:
- Longitudinal study of 2000 mother-child pairs from the Amsterdam Born Children and their Development study.
- Maternal blood samples collected at a median gestational age of 12.9 weeks for free T4 and TSH assessment.
- Offspring problem behavior assessed at 5-6 years using the Strengths and Difficulties Questionnaire completed by parents and teachers.
Main Results:
- Maternal hypothyroxinemia (<5th percentile) was significantly associated with increased odds of teacher-reported hyperactivity/inattention (OR 1.70, 95% CI 1.01-2.86).
- A less stringent cutoff (<10th percentile) showed a similar trend (OR 1.47, 95% CI 0.99-2.20).
- No significant associations were found between maternal thyroid function and parent-reported hyperactivity/inattention or any other problem behaviors.
Conclusions:
- Early maternal thyroid hormone supply disruptions are potentially associated with Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms in offspring.
- The study found no evidence linking maternal thyroid function to other problem behaviors like conduct or emotional issues.
Introduction:
There is evidence, though not consistent, that offspring born to mothers with subtle decreases in thyroid function early in their pregnancies may be at risk of cognitive impairments and attention problems. However, other types of problem behavior have not been addressed thus far. We tested whether maternal thyroid function in early pregnancy is associated with several types of problem behavior in offspring at age 5-6 years.
Methods:
This was a longitudinal study that included the data of 2000 mother-child pairs from the Amsterdam Born Children and their Development study. At a median gestational age of 12.9 (interquartile range: 11.9-14.1) weeks, maternal blood was sampled for assessment of free T4 and TSH. Overall problem behavior, hyperactivity/inattention, conduct problems, emotional problems, peer relationship problems and prosocial behavior were measured at age 5-6 years using the Strengths and Difficulties Questionnaire, which was filled out by both parents and teachers.
Results:
Maternal hypothyroxinaemia <5th percentile was associated with a 1.70 (95% confidence interval (CI): 1.01-2.86) increased odds of teacher-reported hyperactivity/inattention after adjustment for confounders. By increasing the cut-off level to <10th percentile, the odds ratio became 1.47 (95% CI: 0.99-2.20). There were no associations between maternal thyroid function parameters and hyperactivity/inattention as reported by parents, nor with teacher or parent reports of other types of problem behavior.
Conclusions:
Our results partially confirm previous observations, showing that early disruptions in the maternal thyroid hormone supply may be associated with ADHD symptoms in offspring. Our study adds that there is no evidence for an effect on other types of problem behavior.