Association between maternal thyroid function in early pregnancy and neurodevelopment in children aged 0-24 months: a...

To investigate the influence of maternal thyroid function in early pregnancy on offspring neurodevelopment outcomes.

We retrospectively analyzed 20,855 mother-offspring pairs from Shenzhen, China, with delivery dates between February 2016 and May 2024. Maternal thyroid hormone levels were measured at 7-13 gestational weeks. Neurodevelopment outcomes were assessed using the Ages and Stages Questionnaire-Third Edition (ASQ-3) at 0-24 months of age.

Compared with euthyroid mothers, overt hypothyroidism was associated with an increased risk of gross motor delay (adjusted odds ratio [aOR] 2.14; 95% confidence interval [CI] 1.17-3.63). Subclinical hypothyroidism was linked to a higher risk of delay in the problem-solving domain (aOR 1.63; 95% CI 1.03-2.49). Hypothyroxinemia was associated with increased risk of delays in both the gross motor (aOR 1.73; 95% CI 1.04-2.70) and fine motor domains (aOR 1.69; 95% CI 1.01-2.66). Subclinical hyperthyroidism was associated with an elevated risk of gross motor delay (aOR 1.97; 95% CI 1.14-3.18). Maternal thyroid-stimulating hormone (TSH) levels exhibited a U-shaped relationship with the risk of neurodevelopmental delay in the gross motor domain. (P-overall = 0.012; P-nonlinear = 0.003) CONCLUSIONS: Maternal overt hypothyroidism, subclinical hypothyroidism, hypothyroxinemia, and subclinical hyperthyroidism in early pregnancy are associated with neurodevelopmental delays in children. Notably, this association exhibits a U-shaped pattern, whereby both low and high TSH levels are linked to an increased risk of neurodevelopmental delay.