The role of maternal prenatal thyroid function on offspring depression: Findings from the ALSPAC cohort

2019 ◽  
Vol 32 (1) ◽  
pp. 189-196 ◽  
Author(s):  
Dagnachew Muluye Fetene ◽  
Kim S. Betts ◽  
Rosa Alati

AbstractMaternal thyroid dysfunction during pregnancy may contribute to offspring neurobehavioral disorders. In this paper, we investigate the relationship between maternal thyroid function during pregnancy and offspring depression and anxiety. Data were taken from the Avon Longitudinal Study of Parents and Children. A total of 2,920 mother-child pairs were included. Thyroid-stimulating hormone levels, free thyroxine (FT4), and thyroid peroxidase antibodies were assessed during the first trimester of pregnancy because maternal supply is the only source of thyroid hormone for the fetus during the first 12 weeks of gestation. Child symptoms of depression and anxiety were assessed using the Development and Well-Being Assessment at ages 7.5 and 15 years. The odds of presenting with depression and anxiety were estimated using the generalized estimating equation. The level of FT4 during the first trimester of pregnancy was associated with child depression combined at ages 7.5 and 15 (odds ratio = 1.21, 95% confidence interval [1.00, 1.14]. An increase of 1 standard deviation of FT4 during pregnancy increased the odds of child depression by 28% after adjustment made for potential confounders. No association was found among maternal levels of thyroid-stimulating hormone, FT4, and thyroid peroxidase antibodies and childhood anxiety. In conclusion, increased levels of FT4 during the first trimester of pregnancy appear be linked to greater risk of offspring depression.

Author(s):  
Frank A. Quinn ◽  
Gennady N. Gridasov ◽  
Sergey A. Vdovenko ◽  
Natalia A. Krasnova ◽  
Nadezhda V. Vodopianova ◽  
...  

AbstractUndiagnosed thyroid disease is a common problem with significant public health implications. This is especially true during pregnancy, when the health of both the mother and the developing child can be adversely affected by abnormal maternal thyroid function. Measurement of serum thyroid stimulating hormone (TSH) and thyroid peroxidase antibodies (TPO-Ab) are two common ways to assess maternal thyroid status. The objective of our study was to determine the prevalence of abnormal TSH and TPO-Ab tests in a population of pregnant women in the Samara region of the Russian Federation. Serum samples were obtained from 1588 pregnant women as part of their routine antenatal care. TSH and TPO-Ab were measured, and trimester-specific reference values for TSH (2.5–97.5 percentiles) were calculated using TPO-Ab-negative women. TSH results outside these ranges were considered abnormal; TPO-Ab levels outside the manufacturer's reference range (>12IU/mL) were considered abnormal. Overall, the prevalence of abnormal results was 6.3% for TSH and 10.7% for TPO-Ab. High TSH (>97.5 trimester-specific percentile) and TPO-Ab-positive results were most common in the first trimester (5.7% and 13.8%, respectively). TSH levels were associated with gestational age and TPO-Ab status, and with maternal age in TPO-Ab-negative women. TPO-Ab status was associated with both maternal and gestational age. Women with TSH >2.5mIU/L had a significantly increased risk of being TPO-Ab-positive, and this risk increased with age. Based on our data, we conclude that abnormal TSH and TPO-Ab are common in pregnant women of the Samara region. Given the association of thyroid dysfunction to adverse pregnancy outcomes, screening of this population for abnormal thyroid function should be considered.


2013 ◽  
Vol 12 (2) ◽  
pp. 164-171
Author(s):  
Nishat Un Nahar ◽  
Zeba Un Naher ◽  
Md. Ashanul Habib ◽  
Forhadul Hoque Mollah

Introduction: Maternal thyroid dysfunction during pregnancy has been associated with a number of adverse outcomes, like preterm birth, placental abruption, foetal death and impaired neurological development in the child. Simultaneously the presence of antibody to thyroid peroxidase results miscarriage, preterm birth and maternal post partum thyroid disease. Post partum thyroiditis is closely associated with the presence of antibodies to thyroid peroxidase (TPO). Indeed if a pregnant woman is positive for TPO antibodies early in pregnancy, her chances of developing post partum thyroiditis is 30-52%. Objective: To find out the level of TPO-Ab and thyroid status in first trimester of pregnancy. Method: The cross sectional study was designed in Department of Biochemistry, BSMMU, Dhaka. Following inclusion and exclusion criteria 200 sample was selected by purposive and convenient sampling. The study parameters were- thyroid peroxidase antibody (TPO-Ab); serum thyroid stimulating hormone (TSH); serum free thyroxin (FT4). Results: 43 (21.5%) pregnant women of first trimester was found to be TPO-Ab positive, among these 43 subjects 16 (8.0%) had raised TSH i.e. >2.5 mIU/L and 27 had TSH level <2.5 mIU/L. Low serum FT4 was in 9 (4.5%) subjects. The study revealed that, there was a significant positive correlation between positive TPO-Ab (>12 IU/mL) and serum TSH level of study subjects and there was negative correlation between serum TSH (>2.5 mIU/L) and serum FT4 in study subjects. Conclusion: TPO-Ab positivity in first trimester of pregnancy and TPOAb positivity was associated with higher TSH and low FT4 level. Bangladesh Journal of Medical Science Vol. 12 No. 02 April’13 Page 164-170 DOI: http://dx.doi.org/10.3329/bjms.v12i2.14945


2021 ◽  
Vol 10 (25) ◽  
pp. 1857-1861
Author(s):  
Rachita Nanda ◽  
Suprava Patel ◽  
Prasant Kumar Nayak ◽  
Eli Mohapatra ◽  
Sarita Agrawal

BACKGROUND The importance of adequate iodine status in pregnancy is undoubted as its deficiency is associated with adverse pregnancy outcomes for the mother as well as the foetus and neonate. Although median urine iodine concentration can assess iodine status of the population but not at an individual level. The purpose of this study was to assess the nutritional status of iodine and identify its effects on thyroid function during the first trimester of pregnancy. METHODS The study was carried out on 341 euthyroid healthy pregnant women using urine iodine concentration and other parameters of thyroid panel at a tertiary care hospital. RESULTS Median (interquartile range) urine iodine concentration and thyroid stimulating hormone (TSH) were 227.37 (161.7, 343.86) μg / L and 1.8 (1.1, 2.7) mIU / L respectively and Mean ± SD of free thyroxine and thyroid peroxidase antibodies were 14.53 ± 2.02 pmol / L and 38.23 ± 9.29 kIU / L respectively. Only thyroid peroxidase antibodies showed significant difference across groups with different iodine status. A positive correlation of urine iodine concentration (UIC) with thyroid peroxidase antibodies was observed (r = 0.137, P = 0.011). Multiple regression analysis revealed that thyroid peroxidase antibodies can serve as an independent predictor of iodine status in the presence of normal levels of TSH and FT4 (t - 3.063, CI; 0.880, 4.038, P = 0.002). CONCLUSIONS Thyroid peroxidase antibodies progressed positively with increase in urine iodine concentration indicating its role as a marker of iodine nutritional status and for early identification of women who can develop autoimmune thyroiditis resulting in hypothyroidism even prior to elevation of thyroid stimulating hormone levels. KEY WORDS Anti-TPO Ab, Free Thyroxine, Thyroid Stimulating Hormone, Urine Iodine Concentration


2009 ◽  
Vol 2 (4) ◽  
pp. 154-156
Author(s):  
Richard H Lee ◽  
Carole A Spencer ◽  
Martin N Montoro ◽  
Paola Aghajanian ◽  
T Murphy Goodwin ◽  
...  

The aim of the paper is to determine the prevalence of thyroid peroxidase antibodies (TPOAb) and assess its effect on the thyroid-stimulating hormone (TSH) reference range during pregnancy in a primarily Latina population. Serum samples were collected from healthy pregnant women and non-pregnant controls. TSH reference ranges were calculated when TPOAb-positive patients were either included or excluded. A total of 134 pregnant women and 107 non-pregnant controls were recruited. Positive TPOAb titres were found in 23 (17.2%) of the 134 pregnant women, and in 14 (13.1%) of the 107 non-pregnant controls. When the TPOAb-positive women were included in the TSH analysis, the upper reference limit using two different methods was consistently higher: 0–2.2 fold in the non-pregnant women, 2.01–2.78 fold in the first trimester, 3.18–4.7 fold in the second and 1.05–1.42 fold in the third. The lower TSH reference limit was not affected by the inclusion of TPOAb-positive subjects. In conclusion, inclusion of TPOAb-positive patients results in higher upper reference limits during pregnancy.


2016 ◽  
Vol 9 (3) ◽  
pp. 126-129 ◽  
Author(s):  
Helen Robinson ◽  
Philip Robinson ◽  
Michael D’Emden ◽  
Kassam Mahomed

Background First-trimester care of maternal thyroid dysfunction has previously been shown to be poor. This study evaluates early management of thyroid dysfunction in pregnancy in Australia. Methods Patients reviewed by the Obstetric Medicine team for thyroid dysfunction from 1 January 2012 to 30 June 2013 were included. Data were collected on gestation at referral from the patient’s general practitioner to the antenatal clinic, information provided in the referral letter, thyroid function tests and thyroid medications. Results Eighty-five women were included in the study. At the time of general practitioner referral to antenatal services, 19% of women with preexisting thyroid disease had no thyroid function tested. Forty-three percent had an abnormal thyroid-stimulating hormone defined as being outside the laboratory-specific pregnancy reference range if available, or outside the level of 0.1–2.5 mIu/L in the first trimester, 0.2–3.0 mIu/L in the second trimester and 0.3–3.0 mIu/L in the third trimester. Only 21% of women increased their thyroxine dose prior to their first antenatal clinic review. Conclusion This study highlights that a significant proportion of women with known thyroid disease either have untested thyroid function in the first trimester or a thyroid-stimulating hormone outside of levels recommended by guidelines.


2017 ◽  
Vol 10 (1) ◽  
pp. 36 ◽  
Author(s):  
Hyung Wook Choi ◽  
You Jung Han ◽  
Dong Wook Kwak ◽  
So Young Park ◽  
Sung Hoon Kim ◽  
...  

2019 ◽  
Vol 8 (9) ◽  
pp. 1288-1293 ◽  
Author(s):  
Jiashu Li ◽  
Aihua Liu ◽  
Haixia Liu ◽  
Chenyan Li ◽  
Weiwei Wang ◽  
...  

Thyroid dysfunction is a frequently found endocrine disorder among reproductively aged women. Subclinical hypothyroidism is the most common condition of thyroid disorders during pregnancy and is defined as manifesting a thyroid-stimulating hormone concentration exceeding the trimester-specific reference value, with a normal free thyroxine concentration. Here, we evaluated the prospective association between spontaneous miscarriage and first-trimester thyroid function. We conducted a case–control study (421 cases and 1684 controls) that was nested. Thyroid-stimulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) status were measured. We found that higher TSH was related to spontaneous miscarriage (OR 1.21; 95% CI, 1.13–1.30, P < 0.001). Compared with women with TSH levels of 0.4–<2.5 mIU/L, the risk of miscarriage was increased in women with TSH levels of 2.5–<4.87 mIU/L (OR 1.47; 95% CI, 1.16–1.87) and TSH greater than 4.87 mIU/L (OR 1.97; 95% CI, 1.22–3.18). After controlling for the confounding factor, TPOAb positivity status and FT4, the results were similar. The present study showed that higher TSH was associated with miscarriage in early pregnancy. In fact, TSH levels between 2.5 and 4.87 mIU/L increased the risk for miscarriage, with TSH greater than 4.87 mIU/L increasing the risk even further.


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