Impact of maternal subclinical hypothyroidism during the first trimester on brain development of the offspring: a prospective study
10.3760/cma.j.issn.1000-6699.2010.11.002
- VernacularTitle:妊娠早期母亲亚临床甲状腺功能减退症对其后代脑发育影响的前瞻性研究
- Author:
Haibo XUE
;
Yuanbin LI
;
Weipiag TENG
;
Zhongyan SHAN
;
Xiaohui YU
;
Yushu LI
;
Weiwei WANG
;
Yanyan CHEN
;
Jia LI
;
Haixia GUAN
;
Xiaochun TENG
;
Jing LI
;
Yun GAO
;
Chenling FAN
;
Hong WANG
;
Hongmei ZHANG
- Publication Type:Journal Article
- Keywords:
Early pregnancy;
Subclinical hypothyroidism;
Brain development
- From:
Chinese Journal of Endocrinology and Metabolism
2010;26(11):916-920
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the effects of maternal subclinical hypothyroidism (SCH) during the first trimester on neuropsychological development of the offspring by 20-30 months. Methods In this study, 1 761 pregnant women from 10 hospitals with about 8 weeks of gestation were enrolled. Urinary iodine excretion and serum thyrotropin ( TSH ), free thyroxine ( FT4 ), and thyroid peroxidase antibody ( TPOAb ) levels were determined in all subjects. Pregnant women with SCH (TSH≥2.5 mIU/L) were divided into two subgroups using trimester-specific thyroid function reference: group A (2.5 mIU/L≤TSH＜3.93 mIU/L, 18 cases), and group B (TSH ≥3.93 mIU/L, 20 eases). Thirty euthyroid and TPOAb-negative women from the same cohort were selected as controls. Intellectual and motor development score evaluations were performed in the children by 20-30 months of age. Results Children of women with SCH and subgroups A and B had lower mean intelligence scores 6.55,3.39, and 9.40 points compared with those of the control group (P=0. 001, P=0. 125, and P＜0. 001 ); the respective mean motor scores were 6.31,4.35, and 8.07 points being lower than that of the control ( P=0. 003,P=0. 070, and P=0. 001 ). Intelligence scores and motor scores were negatively correlated with TSH levels (r=-0.425, P＜0. 001 and r=-0. 394, P=0. 001 ). Multiple group comparisons revealed that differences of TSH affected intelligence and motor scores (F=9. 277, P＜0. 001 and F=5. 909, P=0. 004). Ordinal logistic regression analysis showed that possibilities for the reduction of filial mental development index ( MDI ) and psychomotor development index ( PDI ) scores in SCH with maternal TSH levels≥3.93 mIU/L were 8.66 and 6.27 times that of controls ( OR = 8.66,95% CI 2.72-27.57, OR =6.27,95% CI 2.03-19.34 ). Conclusion Maternal elevated TSH levels diagnosed by trimester-specific reference during early gestation are independently associated with lowered filial neurodevelopment scores by 20-30 months.
