Maternal thyroid function and child educational attainment: prospective cohort study

Nelson, S. M. , Haig, C. , McConnachie, A. , Sattar, N. , Ring, S. M., Smith, G. D. , Lawlor, D. A. and Lindsay, R. S. (2018) Maternal thyroid function and child educational attainment: prospective cohort study. British Medical Journal, 360, k452. (doi: 10.1136/bmj.k452) (PMID:29463525) (PMCID:PMC5819484)

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Objective: To determine if first trimester maternal thyroid dysfunction is a critical determinant of child scholastic performance and overall educational attainment. Design: Prospective cohort study. Setting: Avon Longitudinal Study of Parents and Children cohort in the UK. Participants: 4615 mother-child pairs with an available first trimester sample (median 10 weeks gestation, interquartile range 8-12). Exposures: Free thyroxine, thyroid stimulating hormone, and thyroid peroxidase antibodies assessed as continuous measures and the seven clinical categories of maternal thyroid function. Main outcome measures: Five age-specific national curriculum assessments in 3580 children at entry stage assessment at 54 months, increasing up to 4461 children at their final school assessment at age 15. Results: No strong evidence of clinically meaningful associations of first trimester free thyroxine and thyroid stimulating hormone levels with entry stage assessment score or Standard Assessment Test scores at any of the key stages was found. Associations of maternal free thyroxine or thyroid stimulating hormone with the total number of General Certificates of Secondary Education (GCSEs) passed (range 0-16) were all close to the null: free thyroxine, rate ratio per pmol/L 1.00 (95% confidence interval 1.00 to 1.01); and thyroid stimulating hormone, rate ratio 0.98 (0.94 to 1.02). No important relationship was observed when more detailed capped scores of GCSEs allowing for both the number and grade of pass or when language, mathematics, and science performance were examined individually or when all educational assessments undertaken by an individual from school entry to leaving were considered. 200 (4.3%) mothers were newly identified as having hypothyroidism or subclinical hypothyroidism and 97 (2.1%) subclinical hyperthyroidism or hyperthyroidism. Children of mothers with thyroid dysfunction attained an equivalent number of GCSEs and equivalent grades as children of mothers with euthyroidism. Conclusions: Maternal thyroid dysfunction in early pregnancy does not have a clinically important association with impaired child performance at school or educational achievement.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Lindsay, Dr Robert and McConnachie, Professor Alex and Smith, Prof George and Nelson, Professor Scott and Haig, Dr Caroline and Sattar, Professor Naveed
Authors: Nelson, S. M., Haig, C., McConnachie, A., Sattar, N., Ring, S. M., Smith, G. D., Lawlor, D. A., and Lindsay, R. S.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:British Medical Journal
Publisher:BMJ Publishing Group
ISSN (Online):1756-1833
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in British Medical Journal 360:k452
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
558301Maternal thyroid status and offspring developmentScott NelsonOffice of the Chief Scientist (CSO)ETM/97MVLS MED - REPRODUCTIVE & MATERNAL MED