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Maternal Thyroid Function in Early Pregnancy and Neuropsychological Performance of the Child at 5 Years of Age

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DOI

Context: Abnormal maternal thyroid function in pregnancy may impair fetal brain development, but more evidence is needed to refine and corroborate the hypothesis.

Objective: To estimate the association between maternal thyroid function in early pregnancy and neuropsychological performance of the child at 5 years of age.

Design: Follow-up study.

Participants: A cohort of 1153 women and their children sampled from the Danish National Birth Cohort. Maternal thyroid-stimulating hormone (TSH) and free thyroxine (fT4) were measured in stored biobank sera from early pregnancy.

Main outcomes measures: Child neuropsychological test results (Wechsler Intelligence Scale/Test of Everyday Attention), test of motor function (Movement Assessment Battery), and results of parent and teacher reports (Behavior Rating Inventory of Executive Function/Strengths and Difficulties Questionnaire).

Results: Altogether 145 children (12.6%) were born to mothers with abnormal thyroid function in the early pregnancy. High maternal TSH and low fT4 were associated with lower child verbal intelligence quotient (adjusted mean difference TSH ≥ 10 mIU/L vs 0.1 to 2.49 mIU/L, -8.9 [95% confidence interval (CI), -15 to -2.4]; fT4 < 10 pmol/l vs 12.0 to 18.99 pmol/l, -13 [95% CI, -19 to -7.3]). Abnormal maternal thyroid function was also associated with adverse motor function and teacher-reported problems of executive function and behavior, and these associations were dominated by exposure to maternal hypothyroxinemia.

Conclusions: Maternal thyroid hormone abnormalities were associated with adverse neuropsychological function of the child at 5 years of age. For intelligence, marked hypothyroidism was important, whereas for motor function and executive and behavior problems, maternal hypothyroxinemia was predominant.

Original languageEnglish
JournalJournal of Clinical Endocrinology and Metabolism
Volume103
Issue2
Pages (from-to)660-670
Number of pages11
ISSN0021-972X
DOIs
Publication statusPublished - 1 Feb 2018

    Research areas

  • Adult, Child Development/physiology, Child, Preschool, Cohort Studies, Denmark/epidemiology, Female, Follow-Up Studies, Humans, Intelligence/physiology, Male, Mothers, Neuropsychological Tests, Pregnancy, Prenatal Exposure Delayed Effects/blood, Thyroid Function Tests/statistics & numerical data, Thyroid Gland/physiology, Young Adult

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