Thyroid function test abnormalities-isolated TPOAb+, SCH and hypothyroxinemia and preschool children's neurodevelopment
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Published on: October 6, 2023
Linlin Zhu1, Yuzhu Teng1, Yufan Guo1
1Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.
Insights
Maternal thyroid function abnormalities before 20 weeks gestation are linked to neurodevelopmental issues in children. This includes problems with peer interactions, inhibition, and hyperactivity, highlighting the importance of monitoring thyroid health during pregnancy.
Area of Science:
- Endocrinology
- Developmental Pediatrics
- Neuroscience
Background:
- Thyroid function test abnormalities during pregnancy are common.
- These abnormalities are associated with adverse neurodevelopmental outcomes in offspring.
- Early detection and management are crucial for fetal and child development.
Purpose of the Study:
- To investigate the association between maternal thyroid dysfunction before 20 weeks of gestation and neurodevelopment in children aged 3-6 years.
- To evaluate cognitive, emotional, and behavioral development in relation to maternal thyroid status.
- To identify specific thyroid abnormalities linked to particular neurodevelopmental challenges.
Main Methods:
- A cohort of 2243 mother-child pairs was analyzed retrospectively.
- Maternal serum thyrotropin, free thyroxine, and thyroid peroxidase antibodies (TPOAb) were measured.
- Children's neurodevelopment was assessed using validated parental questionnaires (Behavior Rating Inventory of Executive Function-Preschool, Strengths and Difficulties Questionnaires).
- Poisson regression models were employed to examine associations, adjusting for confounders.
Main Results:
- Maternal isolated TPOAb positivity was associated with an increased risk of peer problems (OR=1.90).
- Maternal isolated subclinical hypothyroidism (SCH) correlated with higher risks of inhibition, working memory, conduct problems, hyperactivity, and total difficulties.
- Maternal isolated hypothyroxinemia was linked to an increased risk of peer problems (OR=2.71).
Conclusions:
- Maternal thyroid function test abnormalities identified before 20 weeks of gestation may negatively impact children's neurodevelopment.
- Specific abnormalities like TPOAb positivity, SCH, and hypothyroxinemia are associated with distinct neurodevelopmental risks.
- These findings underscore the importance of maternal thyroid monitoring in early pregnancy.
Objective:
Thyroid function test abnormalities are frequent and associated with the offspring's adverse neurodevelopment. This study aimed to examine the relationship between maternal thyroid function test abnormalities before 20 gestational weeks and children's cognitive, emotional and behavioural development at 3-6 years of age.
Patients And Measurements:
A total of 2243 mother-child pairs were included in the final analysis. Maternal thyroid function was evaluated retrospectively during the children's preschool period. The serum thyrotrophin, free thyroxine and thyroid peroxidase antibodies (TPOAb) were detected by chemiluminescence immunoassay during the follow-up period. The neurodevelopmental status of preschoolers aged 3-6 years was evaluated by parental versions of The Behavior Rating Inventory of Executive Function-Preschool and The Strengths and Difficulties Questionnaires. The associations between maternal thyroid function test abnormalities and preschoolers' neurodevelopment were examined using Poisson regression models.
Results:
After adjusting for potential confounders in Poisson regression analyses, it showed that maternal isolated TPOAb positivity before 20 gestational weeks may be associated with the increased risk of abnormalities in peer problems (odds ratio [OR] = 1.90, 95% confidence interval [CI]: 1.26, 287). Maternal isolated SCH before 20 gestational weeks was observed to be related with increased risk of abnormalities in inhibition (OR = 2.73, 95% CI: 1.37, 5.41), working memory (OR = 1.67, 95% CI: 1.04, 2.70), conduct problems (OR = 1.80, 95% CI: 1.05, 3.09), hyperactivity (OR = 1.94, 95% CI:1.08, 3.49) and total difficulties (OR = 1.94, 95% CI: 1.13, 3.34). Maternal isolated hypothyroxinemia before 20 gestational was observed to be related with increased risk of abnormalities in peer problems (OR = 2.71, 95% CI: 1.17, 6.27).
Conclusions:
Thyroid function test abnormalities before 20 gestational weeks may be associated with children's neurodevelopment at 3-6 years of age.
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