Thyroid Function in Early Pregnancy, Child IQ, and Autistic Traits: A Meta-Analysis of Individual Participant Data
Por:
Levie D, Korevaar TIM, Bath SC, Dalmau-Bueno A, Murcia M, Espada M, Dineva M, Ibarluzea JM, Sunyer J, Tiemeier H, Rebagliato M, Rayman MP, Peeters RP and Guxens M
Publicada:
1 ago 2018
Resumen:
Context: Low maternal free T4 (FT4) has been associated with poor child neurodevelopment in some single-center studies. Evidence remains scarce for the potential adverse effects of high FT4 and whether associations differ in countries with different iodine status.
Objective: To assess the association of maternal thyroid function in early pregnancy with child neurodevelopment in countries with a different iodine status.
Design, Setting, and Participants: Meta-analysis of individual participant data from 9036 mother-child pairs from three prospective population-based birth cohorts: INMA [Infancia y Medio Ambiente (Environment and Childhood project) (Spain)], Generation R (Netherlands), and ALSPAC (Avon Longitudinal Study of Parents and Children, United Kingdom). The exclusion criteria were multiple pregnancies, fertility treatments, thyroid-interfering medication usage, and known thyroid disease.
Main Outcomes: Child nonverbal IQ at 5 to 8 years of age, verbal IQ at 1.5 to 8 years of age, and autistic traits within the clinical range at 5 to 8 years of age.
Results: FT4<2.5th percentile was associated with a 3.9-point (95% CI, -5.7 to -2.2) lower nonverbal IQ and a 2.1-point (95% CI, -4.0 to -0.1) lower verbal IQ. Asuggestive association of hypothyroxinemia with a greater risk of autistic traits was observed. FT4>97.5th percentile was associated with a 1.9-fold (95% CI, 1.0 to 3.4) greater risk of autistic traits. No independent associations were found with TSH.
Conclusions: Low maternal FT4 was consistently associated with a lower IQ across the cohorts. Further studies are needed to replicate the findings of autistic traits and investigate the potential modifying role of maternal iodine status. FT4 seems a reliable marker of fetal thyroid state in early pregnancy, regardless of the type of immunoassay.
Filiaciones:
Levie D:
Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
Pompeu Fabra University, Barcelona, Barcelona, Spain
Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, Netherlands
Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Centre, Rotterdam, Netherlands
The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, Netherlands
Korevaar TIM:
Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Centre, Rotterdam, Netherlands
The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, Netherlands
Bath SC:
Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
Dalmau-Bueno A:
Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
Pompeu Fabra University, Barcelona, Barcelona, Spain
Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
:
Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
Espada M:
Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
Clinical Chemistry Unit, Public Health Laboratory of Bilbao, Basque Government, Parque Tecnológico de Bizkaia, Derio, Spain
Dineva M:
Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
Ibarluzea JM:
Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
Departamento de Sanidad Gobierno Vasco, Subdirección de Salud Pública de Guipúzcoa, Donostia - San Sebastián, Spain
Biodonostia Health Research Institute, Donostia - San Sebastián, Spain
Facultad de Psicología, University of the Basque Country UPV/EHU, Donostia - San Sebastián, Spain
Sunyer J:
Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
Pompeu Fabra University, Barcelona, Barcelona, Spain
Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
Hospital del Mar Research Institute, Barcelona, Spain
Tiemeier H:
Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, Netherlands
Department of Social and Behavioral Science, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands
:
Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
Departmento de Medicina, Universitat Jaume I, Castelló de la Plana, Spain
Rayman MP:
Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
Peeters RP:
Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Centre, Rotterdam, Netherlands
Guxens M:
Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
Pompeu Fabra University, Barcelona, Barcelona, Spain
Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, Netherlands
Green Accepted, Bronze
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