Could maternal thyroid function during pregnancy affect daughters’ age at menarche through child growth? A mediation analysis

BackgroundMaternal thyroid dysfunction and autoantibodies were associated with preterm delivery. However, recommendations for cutoff values of thyroperoxidase antibody (TPOAb) positivity and thyroid-stimulating homone (TSH) associated with premature delivery are lacking.ObjectiveTo identify the pregnancy-specific cutoff values for TPOAb positivity and TSH associated with preterm delivery. To develop a nomogram for the risk prediction of premature delivery based on maternal thyroid function in singleton pregnant women without pre-pregnancy complications.MethodsThis study included data from the International Peace Maternity and Child Care Health Hospital (IPMCH) in Shanghai, China, between January 2013 and December 2016. Added data between September 2019 and November 2019 as the test cohort. Youden’s index calculated the pregnancy-specific cutoff values for TPOAb positivity and TSH concentration. Univariate and multivariable logistic regression analysis were used to screen the risk factors of premature delivery. The nomogram was developed according to the regression coefficient of relevant variables. Discrimination and calibration of the model were assessed using the C-index, Hosmer-Lemeshow test, calibration curve and decision curve analysis.Results45,467 pregnant women were divided into the training and validation cohorts according to the ratio of 7: 3. The testing cohort included 727 participants. The pregnancy-specific cutoff values associated with the risk of premature delivery during the first trimester were 5.14 IU/mL for TPOAb positivity and 1.33 mU/L for TSH concentration. Multivariable logistic regression analysis showed that maternal age, history of premature delivery, elevated TSH concentration and TPOAb positivity in the early pregnancy, preeclampsia and gestational diabetes mellitus were risk factors of premature delivery. The C-index was 0.62 of the nomogram. Hosmer-Lemeshow test showed that the Chi-square value was 2.64 (P = 0.955 > 0.05). Decision curve analysis showed a positive net benefit. The calibration curves of three cohorts were shown to be in good agreement.ConclusionsWe identified the pregnancy-specific cutoff values for TPOAb positivity and TSH concentration associated with preterm delivery in singleton pregnant women without pre-pregnancy complications. We developed a nomogram to predict the occurrence of premature delivery based on thyroid function and other risk factors as a clinical decision-making tool.

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Altered maternal thyroid function: Effect of L-carnitine supplementation on fetal and neonatal myocardial free fatty acid oxidation,in vitro

Indian Journal of Clinical Biochemistry ◽

10.1007/bf02867868 ◽

1998 ◽

Vol 13 (2) ◽

pp. 87-91

Author(s):

Ratan Kumar

Keyword(s):

Fatty Acid ◽

Free Fatty Acid ◽

Fatty Acid Oxidation ◽

Thyroid Function ◽

Acid Oxidation ◽

Carnitine Supplementation ◽

Free Fatty Acid Oxidation ◽

Maternal Thyroid

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Maternal thyroid function during pregnancy and child brain morphology: a time window-specific analysis of a prospective cohort

The Lancet Diabetes & Endocrinology ◽

10.1016/s2213-8587(19)30153-6 ◽

2019 ◽

Vol 7 (8) ◽

pp. 629-637 ◽

Cited By ~ 20

Author(s):

Toyah A Jansen ◽

Tim I M Korevaar ◽

Tessa A Mulder ◽

Tonya White ◽

Ryan L Muetzel ◽

...

Keyword(s):

Thyroid Function ◽

Prospective Cohort ◽

Time Window ◽

Brain Morphology ◽

Specific Analysis ◽

Maternal Thyroid

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Maternal Thyroid Function, Use of Antithyroid Drugs in Early Pregnancy, and Birth Defects

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2019-01343 ◽

2019 ◽

Vol 104 (12) ◽

pp. 6040-6048 ◽

Cited By ~ 6

Author(s):

Stine Linding Andersen ◽

Louise Knøsgaard ◽

Jørn Olsen ◽

Peter Vestergaard ◽

Stig Andersen

Keyword(s):

Thyroid Function ◽

Birth Defects ◽

Early Pregnancy ◽

Antithyroid Drug ◽

Maternal Blood ◽

Antithyroid Drugs ◽

Birth Cohorts ◽

Increased Risk ◽

Maternal Thyroid

Abstract Context Antithyroid drug (ATD) therapy in early pregnancy is associated with birth defects, but more data are needed to substantiate the risk associated with different types of ATD. Furthermore, the role of abnormal maternal thyroid function per se remains unclarified. Objective To evaluate the risk of birth defects associated with the use of ATD in an extended nationwide cohort and the role of abnormal maternal thyroid function in birth cohorts including stored maternal blood samples from early pregnancy. Participants Danish pregnant women and their live-born children, including 1,243,353 children from a Nationwide Register-Based Cohort (NRBC), 1997 to 2016; 8830 children from the Danish National Birth Cohort (DNBC), 1997 to 2003; and 14,483 children from the North Denmark Region Pregnancy Cohort (NDRPC), 2011 to 2015. Main Outcome Measures Birth defects diagnosed before 2 years of age. Results In the NRBC, altogether 2718 (0.2%) children had been exposed to ATD in early pregnancy. The overall frequency of birth defects was 6.7% (95% CI, 6.7% to 6.8%) in nonexposed children and higher after exposure to methimazole/carbimazole (9.6%; 95% CI, 8.2% to 11.2%) and propylthiouracil (8.3%; 95% CI, 6.7% to 10.3%). On the other hand, the frequency of maternal thyroid dysfunction in early pregnancy was similar in the random cohort and in cases of birth defect in the DNBC (12.4 vs 12.6%, P = 0.8) and the NDRPC (15.1 vs 15.4%, P = 0.8). Conclusions Results corroborate an increased risk of birth defects associated with the use of ATD in early pregnancy and suggest that abnormal maternal thyroid function is not a major risk factor for birth defects.

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