scholarly journals Associations between maternal thyroid function in pregnancy and child neurodevelopmental outcomes at 20 months in the Seychelles Child Development Study, Nutrition Cohort 2 (SCDS NC2)

2021 ◽  
Vol 10 ◽  
Author(s):  
Anna M. Monaghan ◽  
Maria S. Mulhern ◽  
Emeir M. Mc Sorley ◽  
J.J. Strain ◽  
Theresa Winter ◽  
...  
Keyword(s):  
Child Development ◽  
Thyroid Hormones ◽  
Thyroid Function ◽  
Linear Regression Analysis ◽  
Cognitive Outcomes ◽  
Neurodevelopmental Outcomes ◽  
Development Study ◽  
Free Thyroid Hormones ◽  
Child Neurodevelopment ◽  
Maternal Thyroid

Abstract Maternal thyroid hormones facilitate optimal foetal neurodevelopment; however, the exact role of the thyroid hormones on specific cognitive outcomes is unknown. The present study aimed to investigate associations between maternal thyroid function and neurodevelopmental outcomes in the Seychelles Child Development Study (SCDS) Nutrition 2 cohort (n 1328). Maternal free thyroid hormones (fT3, fT4 and fTSH) were assessed at 28 weeks’ gestation with a range of child cognitive outcomes analysed at 20 months. Dietary iodine intake was analysed for a subset of women through a Food Frequency Questionnaire. Linear regression analysis was used to test associations between serum concentrations of maternal thyroid hormones and child neurodevelopment outcomes. Thyroid hormones were analysed as continuous data and categorised as quintiles. 95% of mothers had optimal thyroid function based on fTSH concentrations. Overall, the present study shows that maternal thyroid function is not associated with neurodevelopmental outcomes in this high fish-eating population. However, a positive association, using quintiles for fT3, was reported for the Mental Developmental Index, between Q3 v. Q4 (β 0⋅073; P 0⋅043) and for Q3 v. Q5 (β value 0⋅086; P 0⋅018). To conclude, mothers in our cohort, who largely have optimal thyroid function and iodine intakes, appear able to regulate thyroid function throughout pregnancy to meet neurodevelopmental needs. However, it is possible that minor imbalances of fT3, as indicated from our secondary analysis, may impact offspring neurodevelopment. Further investigation of the relationship between maternal thyroid function and infant neurodevelopment is warranted, particularly in populations with different dietary patterns and thereby iodine intakes.

scholarly journals Associations of prenatal methylmercury exposure and maternal polyunsaturated fatty acid status with neurodevelopmental outcomes at 7 years of age: results from the Seychelles Child Development Study Nutrition Cohort 2

2020 ◽  
Author(s):  
J J Strain ◽  
Tanzy M Love ◽  
Alison J Yeates ◽  
Daniel Weller ◽  
Maria S Mulhern ◽  
...  
Keyword(s):  
Child Development ◽  
Fetal Brain ◽  
Multiple Comparisons ◽  
Linear Regression Models ◽  
Mehg Exposure ◽  
Neurodevelopmental Outcomes ◽  
Development Study ◽  
Pufa Ratio ◽  
P Values ◽  
Child Neurodevelopment

ABSTRACT Background Fish is a primary source of protein and n-3 PUFA but also contains methylmercury (MeHg), a naturally occurring neurotoxicant to which, at sufficient exposure levels, the developing fetal brain is particularly sensitive. Objectives To examine the association between prenatal MeHg and maternal status of n-3 and n-6 PUFA with neurodevelopment, and to determine whether PUFA might modify prenatal MeHg associations with neurodevelopment. Methods We examined the Seychelles Child Development Study Nutrition Cohort 2 (NC2) at age 7 y. We used a sophisticated and extensive neurodevelopmental test battery that addressed 17 specific outcomes in multiple neurodevelopmental domains: cognition, executive and psychomotor function, language development, behavior, scholastic achievement, and social communication. Analyses were undertaken on 1237 mother-child pairs with complete covariate data (after exclusions) and a measure of at least 1 outcome. We examined the main and interactive associations of prenatal MeHg exposure (measured as maternal hair mercury) and prenatal PUFA status (measured in maternal serum at 28 weeks’ gestation) on child neurodevelopmental outcomes using linear regression models. We applied the Bonferroni correction to account for multiple comparisons and considered P values <0.0029 to be statistically significant. Results Prenatal MeHg exposure and maternal DHA and arachidonic acid (20:4n-6) (AA) status were not significantly associated with any neurodevelopmental outcomes. Findings for 4 outcomes encompassing executive function, cognition, and linguistic skills suggested better performance with an increasing maternal n-6:n-3 PUFA ratio (P values ranging from 0.004 to 0.05), but none of these associations were significant after adjusting for multiple comparisons. No significant interaction between MeHg exposure and PUFA status was present. Conclusions Our findings do not support an association between prenatal MeHg exposure or maternal DHA and AA status with neurodevelopmental outcomes at age 7 y. The roles of n-6 and n-3 PUFA in child neurodevelopment need further research.

scholarly journals Neonates Born to Mothers with Graves’ Disease: 15 Year Experience of a Pediatric Endocrinology Department

2020 ◽  
Vol 33 (7-8) ◽  
pp. 483
Author(s):  
Inês Romão Luz ◽  
João Rio Martins ◽  
Mónica Jerónimo ◽  
Joana Serra Caetano ◽  
Rita Cardoso ◽  
...  
Keyword(s):  
Thyroid Hormones ◽  
Cord Blood ◽  
Thyroid Function ◽  
Case Series ◽  
Function Evaluation ◽  
Graves Disease ◽  
Thyrotropin Receptor ◽  
Second Trimester ◽  
Pediatric Endocrinology ◽  
Free Thyroid Hormones

Introduction: Graves disease is characterized by the existence of autoantibodies directed to the thyrotropin receptor, which can have a stimulatory/inhibitory action, in women with the condition, their fetus or neonate. Our aim was to review the case series of these neonates in order to establish neonatal thyroid function predictors.Material and Methods: Retrospective cohort study of the database of the Department of Pediatric Endocrinology, including patients born to mothers with Graves’ disease, between 2002 and 2017. Clinical and biochemical data were collected from mothers and offspring.Results: Fifty newborns, from 46 women with a median of 3.5 years after diagnosis, were included. During all trimesters of pregnancy, more than half of women had positive autoantibodies directed to the thyrotropin receptor. Not every woman had a complete thyroid function evaluation every trimester. In 32 newborns, cord blood screening was done. During the neonatal period, there were three cases of hypothyroidism and two of hyperthyroidism. The mothers of these five newborns had higher levels of free thyroid hormones during the second trimester (p = 0.03). The level of antibodies directed to the thyrotropin receptor was significantly higher in the cord blood (p = 0.03) and in the first neonatal test (p = 0.03) of these dysthyroid newborns.Discussion: Our results reinforce the need for every pregnant woman with Graves’ disease to be subject to thyroid function and autoantibodies evaluation during every trimester, as well as the importance of evaluating these antibodies in cord blood.Conclusion: High levels of free thyroid hormones during the second trimester of pregnancy and antibodies directed to the thyrotropin receptor value in cord blood are predictors of dysthyroidism in neonates born from women with Grave’s disease.

scholarly journals Maternal Thyroid Function during the Second Half of Pregnancy and Child Neurodevelopment at 6, 12, 24, and 60 Months of Age

2011 ◽  
Vol 2011 ◽  
pp. 1-13 ◽  
Author(s):  
Jonathan Chevrier ◽  
Kim G. Harley ◽  
Katherine Kogut ◽  
Nina Holland ◽  
Caroline Johnson ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Equilibrium Dialysis ◽  
Convincing Evidence ◽  
Free T4 ◽  
Impaired Child ◽  
Motor Functioning ◽  
Child Neurodevelopment ◽  
Maternal Thyroid ◽  
And Behavior

Although evidence suggests that maternal hypothyroidism and mild hypothyroxinemia during the first half of pregnancy alters fetal neurodevelopment among euthyroid offspring, little data are available from later in gestation. In this study, we measured free T4 using direct equilibrium dialysis, as well as total T4 and TSH in 287 pregnant women at 27 weeks' gestation. We also assessed cognition, memory, language, motor functioning, and behavior in their children at 6, 12, 24, and 60 months of age. Increasing maternal TSH was related to better performance on tests of cognition and language at 12 months but not at later ages. At 60 months, there was inconsistent evidence that higher TSH was related to improved attention. We found no convincing evidence that maternal TH during the second half of pregnancy was related to impaired child neurodevelopment.

scholarly journals Finding vulnerable subpopulations in the Seychelles Child Development Study: effect modification with latent groups

2014 ◽  
Vol 26 (2) ◽  
pp. 809-822
Author(s):  
Tanzy MT Love ◽  
Sally W Thurston ◽  
Philip W Davidson
Keyword(s):  
Child Development ◽  
Fish Consumption ◽  
Latent Variable ◽  
Group Membership ◽  
Effect Modification ◽  
Low Doses ◽  
Neurodevelopmental Outcomes ◽  
Development Study ◽  
Mixture Regression ◽  
Methylmercury Exposure

The Seychelles Child Development Study is a research project with the objective of examining associations between prenatal exposure to low doses of methylmercury from maternal fish consumption and children’s developmental outcomes. Whether methylmercury has neurotoxic effects at low doses remains unclear and recommendations for pregnant women and children to reduce fish intake may prevent a substantial number of people from receiving sufficient nutrients that are abundant in fish. The primary findings of the Seychelles Child Development Study are inconsistent with adverse associations between methylmercury from fish consumption and neurodevelopmental outcomes. However, whether there are subpopulations of children who are particularly sensitive to this diet is an open question. Secondary analysis from this study found significant interactions between prenatal methylmercury levels and both caregiver IQ and income on 19-month IQ. These results are sensitive to the categories chosen for these covariates and are difficult to interpret collectively. In this paper, we estimate effect modification of the association between prenatal methylmercury exposure and 19-month IQ using a general formulation of mixture regression. Our mixture regression model creates a latent categorical group membership variable which interacts with methylmercury in predicting the outcome. We also fit the same outcome model when in addition the latent variable is assumed to be a parametric function of three distinct socioeconomic measures. Bayesian methods allow group membership and the regression coefficients to be estimated simultaneously and our approach yields a principled choice of the number of distinct subpopulations. The results show three groups with different response patterns between prenatal methylmercury exposure and 19-month IQ in this population.

Serum free thyroid hormones in different degrees of hypothyroidism and in euthyroid autoimmune thyroiditis

1987 ◽  
Vol 114 (4) ◽  
pp. 559-564 ◽  
Author(s):  
C. Ferrari ◽  
A. Paracchi ◽  
E. Parisio ◽  
F. Codecasa ◽  
M. Mucci ◽  
...  
Keyword(s):  
Thyroid Hormones ◽  
Thyroid Function ◽  
Autoimmune Thyroiditis ◽  
Subclinical Hypothyroidism ◽  
Healthy Subjects ◽  
Direct Determination ◽  
Serum Free ◽  
Free Thyroid Hormones ◽  
Hypothyroid Patients

Abstract. Serum total and free T4 and T3, thyroxinebinding globulin (TBG) and TSH, basal and 20, 30 and 60 min after TRH (200 μg, iv), were evaluated in 125 hypothyroid patients (38 with severe, 23 with mild, and 64 with subclinical hypothyroidism), in 35 euthyroid subjects with autoimmune thyroiditis, and in 51 healthy controls. T4/TBG and T3/TBG ratios were also calculated. A significant decrease in all indices of thyroid function except for T3 occurred simultaneously with a significant increase in basal and TRH-stimulated TSH levels from healthy subjects to subclinical hypothyroids, from subclinical to mild and from mild to severe hypothyroids; euthyroid patients with autoimmune thyroiditis did not differ from healthy subjects. All severe hypothyroid patients had low T4 as well as free T4 (FT4), free T3 (FT3), T4/TBG and T3/TBG ratios, but among mild and subclinical hypothyroids direct determination of FT4 and FT3 proved to be a better index of thyroid function than determination of T4 and T3 even after correction for TBG levels. FT4 was the most commonly abnormal index (19 of 23 subjects with mild and 14 of 64 with subclinical disease). Regression analysis showed that FT4, T4/TBG ratio, T4, and FT3 had a significant inverse correlation with TSH in hypothyroid patients. Discriminant analysis showed that among the thyroid parameters, FT4 is the variable which discriminates best between control subjects and the 3 groups of hypothyroid patients. These data extend previous reports and in a large series of patients confirm the biological meaning and the clinical value of direct measurement of serum free thyroid hormones in hypothyroidism. Nevertheless, the finding that both FT4 and FT3 are in the normal range in some patients with mild and in most with subclinical hypothyroidism indicates that increased TSH secretion remains the most sensitive index of thyroid failure.

scholarly journals Web-Based Intervention to Teach Developmentally Supportive Care to Parents of Preterm Infants: Feasibility and Acceptability Study (Preprint)

2017 ◽  
Author(s):  
Thuy Mai Luu ◽  
Li Feng Xie ◽  
Perrine Peckre ◽  
Sylvana Cote ◽  
Thierry Karsenti ◽  
...  
Keyword(s):  
Child Development ◽  
Supportive Care ◽  
Preterm Infants ◽  
User Satisfaction ◽  
Well Being ◽  
Oral Feeding ◽  
Neurodevelopmental Outcomes ◽  
Web Based ◽  
Child Neurodevelopment ◽  
Developmentally Supportive Care

BACKGROUND Preterm birth affects 8% to 11% of the population and conveys a significant risk of developmental delays. Intervention programs that support child development have been shown to have a positive impact on early motor and cognitive development and on parental well-being. However, these programs are often difficult to implement in a real-life setting due to lack of resources. Hence, our multidisciplinary team developed Mieux Agir au Quotidien (MAQ) to teach developmentally supportive care to parents of preterm infants with the goal of improving child development and parental outcomes. Our intervention included 3 in-person workshops that occurred prior to hospital discharge and a Web-based platform with written and videotaped materials that addressed 5 main themes: (1) infant behavioral cues, (2) flexion positioning; (3) oral feeding support, (4) parent-infant interactions, and (5) anticipation of developmental milestones. OBJECTIVE This study aimed to test the feasibility and acceptability of the intervention by parents of preterm infants and assess clinical benefits on child neurodevelopment and parental outcomes during the first year of life. METHODS A total of 107 infants born at <30 weeks and admitted to Sainte-Justine Hospital neonatal intensive care unit and their parents were enrolled in a nonrandomized controlled before-and-after interventional study (intervention n=55, comparison n=52). Acceptability of the program was assessed with a user satisfaction questionnaire. When the infants were at 4 months’ corrected age, all parents completed questionnaires on infant temperament, parenting stress, sense of competence, and parenting satisfaction. At 12 months’ corrected age, neurodevelopmental testing was performed on infants using the Alberta Infant Motor Scale and the Bayley Scales of Infant and Toddler Development, Third Edition. Comparisons between the 2 groups were done using independent t tests, Wilcoxon rank-sum tests, and Fisher exact tests. RESULTS The majority of parents (43/45) were satisfied with the intervention program and all would recommend MAQ to others. MAQ met their need for evidence-based information that proved useful to support their child development. No difference in parental or child neurodevelopmental outcomes was detected in this pilot study for most outcomes except for higher median scores for parental coercive behaviors in the intervention group, although proportions scoring in the coercive range did not differ. CONCLUSIONS Acceptability of the program was high among parents thus supporting the relevance of such intervention. A larger study using a randomized controlled trial design is needed to better document impact on parent and children and investigate how Web-based technologies can efficiently complement individualized intervention to alleviate the burden on health care resources.

scholarly journals Maternal immune markers during pregnancy and child neurodevelopmental outcomes at age 20 months in the Seychelles Child Development Study

2019 ◽  
Vol 335 ◽  
pp. 577023 ◽  
Author(s):  
Jessica L. Irwin ◽  
Emeir M. McSorley ◽  
Alison J. Yeates ◽  
Maria S. Mulhern ◽  
J.J. Strain ◽  
...  
Keyword(s):  
Child Development ◽  
Immune Markers ◽  
Neurodevelopmental Outcomes ◽  
Development Study

scholarly journals Methyl mercury exposure and neurodevelopmental outcomes in the Seychelles Child Development Study Main cohort at age 22 and 24years

2017 ◽  
Vol 59 ◽  
pp. 35-42 ◽  
Author(s):  
Edwin van Wijngaarden ◽  
Sally W. Thurston ◽  
Gary J. Myers ◽  
Donald Harrington ◽  
Deborah A. Cory-Slechta ◽  
...  
Keyword(s):  
Child Development ◽  
Methyl Mercury ◽  
Mercury Exposure ◽  
Neurodevelopmental Outcomes ◽  
Development Study
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