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Maternal thyroid disorder in pregnancy and risk of cerebral palsy in the child: a population-based cohort study
Tanja Gram Petersen1, Anne-Marie Nybo Andersen2, Peter Uldall3
1Section of Social Medicine, Department of Public Health, University of Copenhagen, Gothersgade 160, 1123, Copenhagen, Denmark. tagp@sund.ku.dk.
Insights
Maternal thyroid disorder during pregnancy may increase the risk of unilateral spastic cerebral palsy in children. However, overall maternal thyroid issues were not linked to bilateral spastic cerebral palsy.
Area of Science:
- Pediatric neurology
- Endocrinology
- Epidemiology
Background:
- Cerebral palsy is the most common childhood motor disability, with largely unknown causes.
- Prenatal thyroid hormone disturbances are hypothesized to increase cerebral palsy risk.
Purpose of the Study:
- To investigate the association between maternal thyroid disorder and the risk of cerebral palsy in offspring.
Main Methods:
- Population-based cohort study involving over 1.4 million children from Denmark and the Nordic countries (MOBAND).
- Utilized register-based and self-reported maternal thyroid disorder data.
- Analyzed risk of cerebral palsy and its subtypes using logistic regression, with follow-up to age 6.
Main Results:
- Maternal thyroid disorder was not associated with bilateral spastic cerebral palsy (OR 1.0; 95% CI: 0.7-1.5).
- Maternal thyroid disorder identified during pregnancy showed an association with increased risk of unilateral spastic cerebral palsy (OR 3.1; 95% CI: 1.2-8.4).
- In the MOBAND cohort, self-reported maternal thyroid disorder in pregnancy was not significantly associated with overall cerebral palsy risk (OR 1.2; 95% CI: 0.6-2.4).
Conclusions:
- Maternal thyroid disorder during pregnancy is linked to an elevated risk of unilateral spastic cerebral palsy.
- No association was found between overall maternal thyroid disorder and bilateral spastic cerebral palsy.
- Further research using maternal blood samples is recommended to validate these findings.
Background:
Cerebral palsy is the most frequent motor disability in childhood, but little is known about its etiology. It has been suggested that cerebral palsy risk may be increased by prenatal thyroid hormone disturbances. The objective of this study was to investigate whether maternal thyroid disorder is associated with increased risk of cerebral palsy.
Methods:
A population-based cohort study using two study populations. 1) 1,270,079 children born in Denmark 1979-2007 identified in nationwide registers, and 2) 192,918 children born 1996-2009 recruited into the Danish National Birth Cohort and The Norwegian Mother and Child Cohort study, combined in the MOthers and BAbies in Norway and Denmark (MOBAND) collaboration cohort. Register-based and self-reported information on maternal thyroid disorder was studied in relation to risk of cerebral palsy and its unilateral and bilateral spastic subtypes using multiple logistic regression. Children were followed from the age of 1 year to the age of 6 years, and cerebral palsy was identified in nationwide registers with verified diagnoses.
Results:
In register data, hypothyroidism was recognized in 12,929 (1.0%), hyperthyroidism in 9943 (0.8%), and unclassifiable thyroid disorder in 753 (< 0.1%) of the mothers. The odds ratio for an association between maternal thyroid disorder and bilateral spastic cerebral palsy was 1.0 (95% CI: 0.7-1.5). Maternal thyroid disorder identified during pregnancy was associated with elevated risk of unilateral spastic cerebral palsy (odds ratio 3.1 (95% CI: 1.2-8.4)). In MOBAND, 3042 (1.6%) of the mothers reported a thyroid disorder in pregnancy, which was not associated with cerebral palsy overall (odds ratio 1.2 (95% CI: 0.6-2.4)).
Conclusions:
Maternal thyroid disorder overall was not related to bilateral spastic cerebral palsy, but maternal thyroid disorder identified in pregnancy was associated with increased risk of unilateral spastic cerebral palsy. These findings should be replicated in studies making use of maternal blood samples.
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