The association of maternal thyroid autoimmunity during pregnancy with child IQ

Derakhshan, A., Korevaar, T. I.M., Taylor, P. N., Levie, D., Guxens, M., Jaddoe, V. W.V., Nelson, S. M. , Tiemeier, H. and Peeters, R. P. (2018) The association of maternal thyroid autoimmunity during pregnancy with child IQ. Journal of Clinical Endocrinology and Metabolism, 103(10), pp. 3729-3736. (doi: 10.1210/jc.2018-00743) (PMID:30020468)

Abstract

Context: Thyroperoxidase antibody (TPOAb) positivity is a major risk factor for gestational thyroid dysfunction. During the first 18-20 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, Participants: This study was embedded in two prospective birth cohorts: Generation R (Rotterdam, the Netherlands) and the Avon Longitudinal Study of Parents and Children (ALSPAC; United Kingdom). Mother-child pairs with available early pregnancy TPOAb data (≤18 weeks of gestation) and offspring IQ were included (N=3637, Generation R and N=2396, ALSPAC). Intervention: None. 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 cut-offs. In ALSPAC, neither TPOAb positivity nor TPOAb concentrations below manufacturer cut-offs were associated with child IQ (TPOAb positivity: 0.7 ±1.0, P=0.45). Adjustment for maternal TSH or FT4 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 if differences between the study populations, such as maternal iodine status, could be the underlying cause for these differences.

• Item Type: Articles
• Additional Information: This work was supported by a clinical fellowship from ZonMw, project number 90 700 412 (to R.P.P.).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Nelson, Professor Scott
• Authors: Derakhshan, A., Korevaar, T. I.M., Taylor, P. N., Levie, D., Guxens, M., Jaddoe, V. W.V., Nelson, S. M., Tiemeier, H., and Peeters, R. P.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Journal of Clinical Endocrinology and Metabolism
• Publisher: Oxford University Press
• ISSN: 0021-972X
• ISSN (Online): 1945-7197
• Published Online: 17 July 2018
• Copyright Holders: Copyright © 2018 Endocrine Society
• First Published: First published in Journal of Clinical Endocrinology and Metabolism 103(10): 3729-3736
• Publisher Policy: Reproduced in accordance with the publisher copyright policy