The Association of Maternal Iodine Status in Early Pregnancy with Thyroid Function in the Swedish Environmental Longitudinal, Mother and Child, Asthma and Allergy Study

Thyroid ◽  
2019 ◽  
Vol 29 (11) ◽  
pp. 1660-1668
Author(s):  
Deborah Levie ◽  
Arash Derakhshan ◽  
Huan Shu ◽  
Maarten A.C. Broeren ◽  
Ralph A. de Poortere ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Early Pregnancy ◽  
Iodine Status ◽  
Child Asthma ◽  
Mother And Child ◽  
Asthma And Allergy

Prenatal exposure to acetaminophen and children's language development at 30 months

2018 ◽  
Vol 51 ◽  
pp. 98-103 ◽  
Author(s):  
C.-G. Bornehag ◽  
A. Reichenberg ◽  
M. Unenge Hallerback ◽  
S. Wikstrom ◽  
H.M. Koch ◽  
...  
Keyword(s):  
Language Development ◽  
Population Based ◽  
Language Delay ◽  
Urinary Concentration ◽  
Main Study ◽  
Confounding By Indication ◽  
Parental Questionnaire ◽  
Child Asthma ◽  
Mother And Child ◽  
Asthma And Allergy

AbstractObjective:To examine prenatal APAP exposure in relation to language development in offspring at 30 months of age.Method:A population-based pregnancy cohort study including 754 women who enrolled in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy (SELMA) study in pregnancy week 8–13. Two exposure measures were used: (1) maternally reported number of APAP tablets taken between conception and enrollment; (2) APAP urinary concentration at enrollment. Language development at 30 months was assessed by nurse's evaluation and parental questionnaire, including the number of words the child used (<25, 25–50 and >50). Main study outcome; parental report of use of fewer than 50 words, termed language delay (LD).Results:59.2% of women enrolled in weeks 8–13 reported taking APAP between conception and enrollment. APAP was measurable in all urine samples and urinary APAP was correlated with the number of APAP taken during pregnancy (P<0.01). Language delay was more prevalent in boys (12.6%) than girls (4.1%) (8.5% in total). Both the number of APAP tablets and urinary APAP concentration were associated with greater LD in girls but not in boys. The adjusted odds ratio (OR) for LD among girls whose mothers reported >6vs.0 APAP tablets was 5.92 (95% confidence interval (CI) 1.10–31.94). The OR for LD in girls whose mothers’ urinary APAP was in the highest compared to the lowest quartile was 10.34 (95% CI 1.37–77.86). While it cannot be ruled out, our available data do not support confounding by indication.Conclusions:Given the prevalence of prenatal APAP use and the importance of language development, these findings, if replicated, would suggest that pregnant women should limit their use of this analgesic during pregnancy.

scholarly journals Thyroid Function in Early Pregnancy, Child IQ, and Autistic Traits: A Meta-Analysis of Individual Participant Data

2018 ◽  
Vol 103 (8) ◽  
pp. 2967-2979 ◽  
Author(s):  
Deborah Levie ◽  
Tim I M Korevaar ◽  
Sarah C Bath ◽  
Albert Dalmau-Bueno ◽  
Mario Murcia ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Early Pregnancy ◽  
Meta Analysis ◽  
Autistic Traits ◽  
Individual Participant Data ◽  
Thyroid State ◽  
Verbal Iq ◽  
Iodine Status ◽  
Child Neurodevelopment ◽  
Individual Participant

Abstract Context Low maternal free T4 (FT4) has been associated with poor child neurodevelopment in some single-center studies. Evidence remains scarce for the potential adverse effects of high FT4 and whether associations differ in countries with different iodine status. Objective To assess the association of maternal thyroid function in early pregnancy with child neurodevelopment in countries with a different iodine status. Design, Setting, and Participants Meta-analysis of individual participant data from 9036 mother–child pairs from three prospective population-based birth cohorts: INMA [Infancia y Medio Ambiente (Environment and Childhood project) (Spain)], Generation R (Netherlands), and ALSPAC (Avon Longitudinal Study of Parents and Children, United Kingdom). The exclusion criteria were multiple pregnancies, fertility treatments, thyroid-interfering medication usage, and known thyroid disease. Main Outcomes Child nonverbal IQ at 5 to 8 years of age, verbal IQ at 1.5 to 8 years of age, and autistic traits within the clinical range at 5 to 8 years of age. Results FT4 &lt;2.5th percentile was associated with a 3.9-point (95% CI, −5.7 to −2.2) lower nonverbal IQ and a 2.1-point (95% CI, −4.0 to −0.1) lower verbal IQ. A suggestive association of hypothyroxinemia with a greater risk of autistic traits was observed. FT4 &gt;97.5th percentile was associated with a 1.9-fold (95% CI, 1.0 to 3.4) greater risk of autistic traits. No independent associations were found with TSH. Conclusions Low maternal FT4 was consistently associated with a lower IQ across the cohorts. Further studies are needed to replicate the findings of autistic traits and investigate the potential modifying role of maternal iodine status. FT4 seems a reliable marker of fetal thyroid state in early pregnancy, regardless of the type of immunoassay.

scholarly journals Reference Ranges and Determinants of Thyroid Function During Early Pregnancy: The SELMA Study

2018 ◽  
Vol 103 (9) ◽  
pp. 3548-3556 ◽  
Author(s):  
Arash Derakhshan ◽  
Huan Shu ◽  
Maarten A C Broeren ◽  
Ralph A de Poortere ◽  
Sverre Wikström ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Population Based ◽  
Reference Ranges ◽  
Free Triiodothyronine ◽  
Free T4 ◽  
Serum Cotinine ◽  
Child Asthma ◽  
Mother And Child ◽  
Total Triiodothyronine ◽  
Main Determinants

Abstract Context Establishing reference ranges as well as identifying and quantifying the determinants of thyroid function during pregnancy is important for proper clinical interpretation and optimizing research efforts. However, such data are sparse, specifically for triiodothyronine measurements, and most studies do not take into account thyroid antibodies or human chorionic gonadotropin. Objective To determine reference ranges and to identify/quantify determinants of TSH, free T4 (FT4), free triiodothyronine (FT3), total T4 (TT4), and total triiodothyronine (TT3). Design, Setting, and Participants This study included 2314 participants of the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy study, a population-based prospective pregnancy cohort of mother-child pairs. Reference ranges were calculated by 2.5th to 97.5th percentiles after excluding thyroperoxidase antibody (TPOAb)–positive and/or thyroglobulin antibody (TgAb)–positive women. Intervention None. Main Outcome Measures TSH, FT4, FT3, TT4, and TT3 in prenatal serum. Results After exclusion of TPOAb-positive women, reference ranges were as follows: TSH, 0.11 to 3.48 mU/L; FT4, 11.6 to 19.4 pmol/L; FT3, 3.72 to 5.92 pg/mL; TT4, 82.4 to 166.2 pmol/L; and TT3, 1.28 to 2.92 nmol/L. Additional exclusion of TgAb-positive women did not change the reference ranges substantially. Exposure to tobacco smoke, as assessed by questionnaires and serum cotinine, was associated with lower TSH and higher FT3 and TT3. Body mass index (BMI) and gestational age were the main determinants of TSH (only for BMI), FT4, FT3, TT4, and TT3. Conclusions We show that the exclusion of TgAb-positive women on top of excluding TPOAb-positive women hardly affects clinical reference ranges. We identified various relevant clinical determinants of TSH, FT4, FT3, TT4, and TT3 that could reflect endocrine-disrupting effects and/or effects on thyroid hormone transport or deiodination.

scholarly journals Mother and Infant Nutrition Investigation in New Zealand (MINI Project): Protocol for an Observational Longitudinal Cohort Study

10.2196/18560 ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. e18560
Author(s):  
Ying Jin ◽  
Jane Coad ◽  
Shao J Zhou ◽  
Sheila Skeaff ◽  
Cheryl Benn ◽  
...  
Keyword(s):  
Cohort Study ◽  
New Zealand ◽  
Thyroid Function ◽  
Postnatal Depression ◽  
Infant Nutrition ◽  
Trial Registration ◽  
Longitudinal Cohort Study ◽  
First Year ◽  
Selenium Status ◽  
Iodine Status

Background Thyroid dysfunction is associated with cognitive impairment, mood disturbance, and postnatal depression. Sufficient thyroid hormone synthesis requires adequate intake of iodine, selenium, and iron. Iodine deficiency was historically a problem for New Zealand, and initiatives were introduced to overcome the problem: (1) mandatory fortification of all bread (except organic) with iodized salt (2009) and (2) provision of subsidized iodine supplements for pregnant and breastfeeding women (2010). Subsequent to these initiatives, most adults and children have adequate iodine status; however, status among breastfeeding women and their infants remains unclear. This paper outlines the methodology of the Mother and Infant Nutrition Investigation (MINI) study: an observational longitudinal cohort study of breastfeeding women and their infants. Objective This study will determine (1) women’s iodine intake and status among supplement users and nonusers; (2) women’s intake and status of iodine, selenium, and iron relating to thyroid function; (3) associations between women’s selenium status, thyroid function, and postnatal depression; (4) infants’ iodine and selenium status relating to first year neurodevelopment. Methods Breastfeeding women aged over 16 years with a healthy term singleton infant were recruited from Manawatu, New Zealand. Participants attended study visits 3, 6, and 12 months postpartum. Maternal questionnaires investigated supplement use before and after birth, iodine knowledge, and demographic information. Dietary assessment and urine, blood, and breast milk samples were taken to measure iodine, selenium, and iron intake/status. The Edinburgh Postnatal Depression Scale was used repeatedly to screen for postnatal depression. Thyroid hormones (free triiodothyronine, free thyroxine, thyroid stimulating hormone, thyroglobulin, antithyroglobulin antibodies, and antithyroid peroxidase) were measured in blood samples, and thyroid gland volume was measured by ultrasound at 6 months postpartum. Infant iodine and selenium concentrations were determined in urine. The Ages and Stages Questionnaire was used to assess infant development at 4, 8, and 12 months. Results Data collection was completed. Biological samples analysis, excluding nail clippings, is complete. Data analysis and presentation of the results will be available after 2020. Conclusions This study will provide data on the current iodine status of breastfeeding women. It will also provide a greater understanding of the three essential minerals required for optimal thyroid function among breastfeeding women. The prospective longitudinal design allows opportunities to examine women’s mental health and infant neurodevelopment throughout the first year, a crucial time for both mothers and their infants. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12615001028594; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369324 International Registered Report Identifier (IRRID) DERR1-10.2196/18560

scholarly journals Variation of iodine status during pregnancy and its associations with thyroid function in women from Rio de Janeiro, Brazil

2019 ◽  
pp. 1-9 ◽  
Author(s):  
Carolina Martins Corcino ◽  
Tatiana Martins Benvenuto Louro Berbara ◽  
Débora Ayres Saraiva ◽  
Nathalie Anne de Oliveira e Silva de Morais ◽  
Annie Schtscherbyna ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Rio De Janeiro ◽  
Urinary Iodine ◽  
Urinary Iodine Concentration ◽  
Thyroid Antibodies ◽  
Third Trimester ◽  
Iodine Status ◽  
The Third ◽  
Increased Risk

AbstractObjectiveTo assess iodine status and its effects on maternal thyroid function throughout pregnancy.DesignIn the present prospective cohort study, three urinary samples were requested for urinary iodine concentration (UIC) determinations in both the first and third gestational trimesters. Serum thyrotropin (TSH) and free thyroxine (FT4) were analysed in both trimesters and thyroid antibodies were assessed once.SettingRio de Janeiro, Brazil.ParticipantsFirst-trimester pregnant women (n243), of whom 100 were re-evaluated during the third trimester.ResultsIodine sufficiency was found in the studied population (median UIC=216·7 µg/l). The first- and third-trimester median UIC was 221·0 and 208·0 µg/l, respectively. TSH levels (mean (sd)) were higher in the third trimester (1·08 (0·67)v. 1·67 (0·86) mIU/l;P<0·001), while FT4levels decreased significantly (1·18 (0·16)v. 0·88 (0·12) ng/dl;P<0·001), regardless the presence of iodine deficiency (UIC<150 µg/l) or circulating thyroid antibodies. UIC correlated (β; 95% CI) independently and negatively with age (–0·43; –0·71, –0·17) and positively with multiparity (0·15; 0·02, 0·28) and BMI (0·25; 0·00, 0·50). Furthermore, median UIC per pregnant woman tended to correlate positively with TSH (0·07; –0·01, 0·14). Women with median UIC≥250 µg/l and at least one sample ≥500 µg/l throughout pregnancy had a higher risk of subclinical hypothyroidism (OR=6·6; 95% CI 1·2, 37·4).ConclusionsIn this cohort with adequate iodine status during pregnancy, excessive UIC was associated with an increased risk of subclinical hypothyroidism.

scholarly journals Comparison of Maternal and Perinatal Outcome in Pregnant Women with Hypothyroidism Diagnosed before Conception with Hypothyroidism Diagnosed during Pregnancy

2014 ◽  
Vol 2 (2) ◽  
pp. 21-27
Author(s):  
P Basnet ◽  
N Aggrawal ◽  
V Suri ◽  
P Dutta ◽  
K Mukhopadhyay
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Thyroid Function ◽  
Early Pregnancy ◽  
Perinatal Outcome ◽  
Fetal Outcome ◽  
Endocrine Disorder ◽  
Fetal Birth Weight ◽  
Group A ◽  
Group B

BACKGROUND: Thyroid disorder is one of commonest endocrine disorder in women and hence constitutes a common endocrine disorder complicating pregnancy. Diagnosing and treating hypothyroidism preconceptionally and during early pregnancy appears to be a useful strategy to improve maternal and fetal outcome. OBJECTIVE: To compare the maternal and perinatal outcome in pregnant women with hypothyroidism diagnosed preconceptionally with hypothyroidism diagnosed during pregnancy. METHODS: A prospective study. One hundred pregnant women with hypothyroidism at less than 20 weeks Period of Gestation (POG) were recruited for the study and grouped into two groups: Group A-hypothyroidism diagnosed and on treatment before conception, Group B-hypothyroidism diagnosed and started on treatment during pregnancy. Both groups were intensively monitored during pregnancy with serial Thyroid Function Test (TFT) and thyroxine replacement doses were adjusted accordingly. Various maternal, perinatal and fetal outcome measures were studied in both groups prospectively till delivery. RESULTS: The maternal and fetal complications were comparable in the two groups, however the fetal birth weight was significantly higher in Group A versus Group B (2.89±0.485kg vs. 2.70±0.453kg; p=0.039). All the new born babies had normal thyroid function. CONCLUSION: Hypothyroidism diagnosed preconceptionally or during early pregnancy and treated appropriately has beneficial effect on fetal birth weight, and hence the total pregnancy outcome. Screening for thyroid dysfunction should be judiciously performed in all high risk women prior to a planned conception or during their first antenatal visit. DOI: http://dx.doi.org/10.3126/jucms.v2i2.11170   Journal of Universal College of Medical Sciences (2014) Vol.2(2): 21-27

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

2019 ◽  
Vol 104 (12) ◽  
pp. 6040-6048 ◽  
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.

The Association of Therapy Adherence and Thyroid Function in Adult Patients with Phenylketonuria

2019 ◽  
Vol 75 (1) ◽  
pp. 16-23 ◽  
Author(s):  
Csaba Sumanszki ◽  
Erika Kiss ◽  
Erika Simon ◽  
Erika Galgoczi ◽  
Aron Soos ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Thyroid Stimulating Hormone ◽  
Healthy Controls ◽  
Serum Thyroglobulin ◽  
Therapy Adherence ◽  
Iodine Status ◽  
Amino Acid Mixtures ◽  
Therapy Compliance

Background: The standard, lifelong therapy of phenylketonuria (PKU) is a natural protein-restricted diet complemented with phenylalanine (Phe)-free L-amino acid mixtures that provide the daily necessary micronutrients. Objective: To assess thyroid function and structure and the iodine status of early-treated adult PKU (ETPKU) patients in Hungary. Methods: Sixty-nine PKU patients (aged 18–41 years) and 50 healthy controls were enrolled in the study. Thyroid hormones, serum thyroglobulin, thyroid antibodies, urinary iodine, and selenium concentrations were measured, and thyroid ultrasound was performed. Results: The incidence of thyroid dysfunction was infrequent (n = 2). Blood Phe was negatively correlated with thyroid-stimulating hormone (TSH), and PKU patients had higher free thyroxine and lower TSH levels than healthy controls. Although optimal iodine status was found in the entire PKU population, by dividing the patients according to their therapy compliance, we observed that lower therapy adherence was associated with mild iodine deficiency and lower urinary selenium levels. Conclusions: The results of this study suggest that iodine status is strongly influenced by the adherence to therapy in ETPKU patients. No or not enough medical food consumption combined with a low-Phe diet can lead to subclinical iodine deficiency.

scholarly journals Thyroid Function and 25 (OH) Vitamin D Level among Sudanese Women in Early Pregnancy

2018 ◽  
Vol 6 (3) ◽  
pp. 488-492
Author(s):  
Imad R. Musa ◽  
Duria A. Rayis ◽  
Mohmamed A. Ahmed ◽  
Ammar H. Khamis ◽  
Abubakr M. Nasr ◽  
...  
Keyword(s):  
Vitamin D ◽  
Thyroid Function ◽  
Early Pregnancy ◽  
Cross Sectional Study ◽  
The Body ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vitamin D Levels ◽  
The Mean ◽  
25 Oh Vitamin D

AIM: A cross-sectional study was conducted at Saad Abualila Hospital (Khartoum, Sudan) to evaluate the vitamin D levels and thyroid function among pregnant Sudanese women (132) in early pregnancy.METHODS: A cross-sectional study was conducted at Saad Abualila hospital (Khartoum, Sudan) during the period from March to July 2015. Women who were in early pregnancy with a singleton pregnancy were approached to participate in the study after signing informed consent. A sample size of 132 participants was calculated guided by the normal interval of thyroid function in Sudanese women in the first trimester and not the level of 25(OH) vitamin D. The 25 - hydroxyvitamin D (25 (OH) vitamins levels were measured using an electrochemiluminescence immunoassay on an Elecsys 2010 Analyzer (Roche Diagnostics, Mannheim, Germany).RESULTS: The mean (SD) of age, gravidity and gestational age was 27.6 (5.5) years, 2.2 (1.6) and 10.4 (2.2) weeks, respectively. The mean (SD) of the body mass index (BMI) and haemoglobin was 27.1 (5.2) kg/m2 and 10.8 (1.1) g/dl, respectively. Median (interquartile) values of TSH, FT3, and FT4 were 1.164 IU/ml (0.079 -2.177 IU/ml), 4.639 nmol/l (3.843 - 6.562 nmol/l), and 16.86 pmol/l (13.02 - 31.48 pmol/l), respectively. There was no significant correlation between vitamin D levels and TSH, FT3 and FT4CONCLUSION: There is no correlation between 25 (OH) vitamin D levels and thyroid function during early pregnancy among Sudanese pregnant women, despite prevalent vitamin D deficiency among these women.

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