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Associations between newborn thyroid-stimulating hormone concentration and neurodevelopment and growth of children at
Molla Mesele Wassie1,2, Lisa Gaye Smithers3,4, Lisa Nicole Yelland3,5
1School of Agriculture Food and Wine, Faculty of Sciences, The University of Adelaide, Adelaide, Australia.
Insights
Newborn thyroid-stimulating hormone (TSH) levels, indicating early iodine nutrition, showed no significant association with childhood neurodevelopment or growth in two studies. Further longitudinal research is needed for older children.
Area of Science:
- Endocrinology and Child Development
- Nutritional Epidemiology
- Public Health Nutrition
Background:
- Newborn thyroid-stimulating hormone (TSH) concentration is a key indicator of early-life iodine status.
- Iodine is crucial for thyroid hormone production, essential for fetal and infant brain development.
- Understanding the impact of TSH levels on neurodevelopment and growth is vital for public health interventions.
Purpose of the Study:
- To investigate the association between newborn TSH levels and neurodevelopmental and growth outcomes at 18 months of age.
- To compare these associations in settings with borderline iodine deficiency (DOMInO Study) versus iodine sufficiency (PINK Study).
Main Methods:
- Utilized data from 1467 children across two pregnancy cohorts (DOMInO and PINK studies).
- Newborn TSH concentrations were obtained from routine screening.
- Neurodevelopment assessed using Bayley Scales of Infant and Toddler Development (Bayley-III) at 18 months; anthropometric measurements (weight, height, head circumference) were also taken.
Main Results:
- No consistent significant differences in Bayley-III cognitive, language, or motor scores were observed between the highest and lowest TSH quartiles across both studies.
- A 1 mIU/l increase in TSH was associated with minimal changes in cognitive scores (-0.3 points in DOMInO, +0.2 points in PINK), with null findings for motor and language domains.
- No significant association was found between newborn TSH levels and anthropometric measurements (z scores for weight, height, head circumference) in either study.
Conclusions:
- Newborn TSH concentration, as a marker of early iodine status, did not show a significant association with neurodevelopment or growth at 18 months in these cohorts.
- The findings suggest that iodine status within the range observed in these studies may not critically impact early neurodevelopment and growth.
- Longitudinal studies assessing neurodevelopment in older children are recommended, as early assessments may not fully predict later developmental trajectories.
Abstract:
The study aimed to assess the associations between newborn thyroid-stimulating hormone (TSH) concentration, a marker of iodine nutrition in early life, and childhood neurodevelopment and growth using data collected from two pregnancy studies, one in a borderline iodine-deficient setting (DHA to Optimize Mother Infant Outcome (DOMInO) Study) and one in an iodine-sufficient setting (Pregnancy Iodine and Neurodevelopment in Kids (PINK) Study). TSH data were obtained from routine newborn screening. Neurodevelopment was assessed at 18 months using the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III). Weight, height and head circumference were measured at 18 months. In total, 1467 children were included in the analysis. Comparing the highest with the lowest TSH quartile, the mean differences (MD) in the Bayley-III scores ranged from -2·0 (95 % CI -4·7, 0·7) to -2·2 (95 % CI -5·8, 1·3) points in DOMInO and 1·0 (95 % CI -1·6, 3·6) to 2·0 (95 % CI -0·4, 4·4) points in PINK in the cognitive, language and motor scales; the MD in the anthropometric z scores ranged from -0·01 (95 % CI -0·5, 0·5) to -0·5 (95 % CI -0·9, -0·1) in both studies. A 1 mIU/l increase in TSH was associated with -0·3 (95 % CI -0·9, 0·2) point and 0·2 (95 % CI -0·3, 0·7) point changes in the mean cognitive score in the DOMInO and PINK, respectively. A null association between TSH and growth was also observed in both studies. Longitudinal studies that utilise newborn TSH data and examine neurodevelopmental outcomes at later ages are warranted, as neurodevelopmental assessments in older children are more predictive of later achievement.
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