Maternal cognitive function during pregnancy in relation to hypo- and hyperthyroxinemia

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Neuroscience

Background:

• Thyroid dysfunction is a known contributor to cognitive dysfunction.
• Cognitive impairment is frequently observed during pregnancy.
• Understanding factors affecting maternal cognition is crucial for prenatal care.

Purpose of the Study:

• To investigate the association between maternal hypothyroxinemia in early pregnancy and cognitive dysfunction.
• To determine if this relationship persists after accounting for confounding factors like depression and sleep disturbances.

Main Methods:

• A prospective follow-up study involving 2082 healthy pregnant women.
• Cognitive function, depression, and sleep problems were assessed via self-report questionnaires at 12, 22, and 32 weeks of gestation.
• Maternal thyroid function (FT4, TSH, TPO-Ab) was measured at 12 weeks of gestation.

Main Results:

• Women with hypothyroxinemia (FT4 <2.5th percentile, normal TSH) at 12 weeks showed significantly higher cognitive dysfunction scores throughout pregnancy (P=.001).
• Poor cognitive function was independently associated with hypothyroxinemia (OR: 2.9), even after adjusting for depression (OR: 3.1) and sleep problems (OR: 2.8).
• Women with both hypothyroxinemia and positive TPO-Ab titres exhibited the highest levels of cognitive dysfunction.

Conclusions:

• Maternal hypothyroxinemia in early pregnancy is a significant risk factor for cognitive dysfunction persisting throughout gestation.
• These findings highlight the importance of monitoring thyroid function during pregnancy to support maternal cognitive health.
• Early identification and management of hypothyroxinemia may help mitigate cognitive impairments in pregnant individuals.