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The association of maternal thyroid autoimmunity during pregnancy with child IQ

Derakhshan, Arash, Korevaar, Tim I M, Taylor, Peter, Levie, Deborah, Guxens, Monica, Jaddoe, Vincent W V, Nelson, Scott M, Tiemeier, Henning and Peeters, Robin P 2018. The association of maternal thyroid autoimmunity during pregnancy with child IQ. Journal of Clinical Endocrinology & Metabolism 103 (10) , pp. 3729-3736. 10.1210/jc.2018-00743

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Abstract

Context Thyroperoxidase antibody (TPOAb) positivity is a major risk factor for gestational thyroid dysfunction. During the first 18 to 20 weeks of pregnancy, high concentrations of human chorionic gonadotropin (hCG) stimulate the thyroid to ensure adequate thyroid hormone availability for the developing fetus. However, TPOAb-positive women have an impaired thyroidal response to hCG stimulation. Objective To study the association of maternal TPOAb positivity during pregnancy with child IQ. Design, Setting, and Participants This study was embedded in two prospective birth cohorts: Generation R (Rotterdam, the Netherlands) and Avon Longitudinal Study of Parents and Children (ALSPAC; United Kingdom). Mother-child pairs with available data on early pregnancy TPOAb (≤18 weeks of gestation) and offspring IQ were included (n = 3637 for Generation R and n = 2396 for ALSPAC). Main Outcome Measures Child IQ at 5 to 10 years of age. Results In Generation R, TPOAb positivity was associated with a 2.0 ± 0.9-point lower mean child IQ (P = 0.03). Sensitivity analyses showed negative effect estimates already from TPOAb concentrations considerably lower than currently used manufacturer cutoffs. In ALSPAC, neither TPOAb positivity nor TPOAb concentrations below manufacturer cutoffs were associated with child IQ (TPOAb positivity: 0.7 ± 1.0; P = 0.45). Adjustment for maternal TSH or free T4 concentrations or urinary iodine/creatinine ratio did not change the results. Conclusion TPOAb positivity during pregnancy was associated with lower child IQ in Generation R but not in ALSPAC. Further studies are needed to elucidate whether differences between the study populations, such as maternal iodine status, could be the underlying cause for these differences.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: The Endocrine Society
ISSN: 0021-972X
Date of First Compliant Deposit: 17 April 2019
Date of Acceptance: 12 April 2018
Last Modified: 17 Jul 2019 02:05
URI: http://orca.cf.ac.uk/id/eprint/117403

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