scholarly journals Controlled Antenatal Thyroid Screening II: effect of treating maternal suboptimal thyroid function on child cognition

2018 ◽  
Author(s):  
Hales C ◽  
Taylor PN ◽  
Channon S ◽  
Paradice R ◽  
McEwan K ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Thyroid Screening ◽  
Child Cognition

scholarly journals Controlled Antenatal Thyroid Screening II: Effect of Treating Maternal Suboptimal Thyroid Function on Child Behavior

2019 ◽  
Vol 105 (3) ◽  
pp. e417-e427 ◽  
Author(s):  
Charlotte Hales ◽  
Peter N Taylor ◽  
Sue Channon ◽  
Kirsten McEwan ◽  
Anita Thapar ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Effect Size ◽  
Controlled Trial ◽  
Autism Spectrum ◽  
Thyroid Screening ◽  
Child Cognition ◽  
Child Adhd ◽  
The Social ◽  
Child Neurodevelopment ◽  
The Uk

Abstract Context & Objectives The Controlled Antenatal Thyroid Screening (CATS) study was the first randomized controlled trial to investigate effects of treating suboptimal gestational thyroid function (SGTF) on child cognition. Since observational studies indicated that SGTF may also increase symptoms of autism and attention-deficit/hyperactivity disorder (ADHD), the CATS cohort was used to investigate whether treatment of mothers affected their children’s behavior. Design & Participants Mothers (N = 475) completed 3 questionnaires: the Strengths and Difficulties Questionnaire (SDQ), the Child ADHD Questionnaire, and the Social Communication Questionnaire (SCQ, used as a screen for autism spectrum disorder [ASD]), about their children (mean age 9.5 years). Group comparisons of total scores, numbers of children above clinical thresholds, and association between high maternal free thyroxine (FT4) (> 97.5th percentile of the UK cohort, “overtreated”) and child neurodevelopment were reported. Results There were no differences in total scores between normal gestational thyroid function (GTF) (n = 246), treated (n = 125), and untreated (n = 104) SGTF groups. More children of treated mothers scored above clinical thresholds, particularly the overtreated. Scores were above thresholds in SDQ conduct (22% vs 7%), SCQ total scores (7% vs 1%), and ADHD hyperactivity (17% vs 5%) when comparing overtreated (n = 40) and untreated (N = 100), respectively. We identified significantly higher mean scores for SDQ conduct (adjusted mean difference [AMD] 0.74; 95% confidence interval [CI], 0.021-1.431; P = 0.040, effect size 0.018) and ADHD hyperactivity (AMD 1.60, 95% CI, 0.361-2.633; P = 0.003, effect size 0.028) comparing overtreated with normal-GTF children. Conclusions There was no overall association between SGTF and offspring ADHD, ASD, or behavior questionnaire scores. However, children of “overtreated” mothers displayed significantly more ADHD symptoms and behavioral difficulties than those of normal-GTF mothers. Thyroxine supplementation during pregnancy requires monitoring to avoid overtreatment.

scholarly journals Controlled Antenatal Thyroid Screening II: Effect of Treating Maternal Suboptimal Thyroid Function on Child Cognition

2018 ◽  
Vol 103 (4) ◽  
pp. 1583-1591 ◽  
Author(s):  
Charlotte Hales ◽  
Peter N Taylor ◽  
Sue Channon ◽  
Ruth Paradice ◽  
Kirsten McEwan ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Thyroid Screening ◽  
Child Cognition

scholarly journals CONTROVERSIES IN ENDOCRINOLOGY: On the need for universal thyroid screening in pregnant women

2014 ◽  
Vol 170 (1) ◽  
pp. R17-R30 ◽  
Author(s):  
Lluís Vila ◽  
Inés Velasco ◽  
Stella González ◽  
Francisco Morales ◽  
Emilia Sánchez ◽  
...  
Keyword(s):  
Thyroid Function ◽  
First Trimester ◽  
Specific Reference ◽  
Geographic Variations ◽  
Scientific Societies ◽  
Need For Treatment ◽  
Positive Effects ◽  
Thyroid Screening ◽  
Iodine Supplementation ◽  
Widespread Agreement

There is a well-known controversy among scientific societies regarding the recommendation to screen for thyroid dysfunction (TD) during pregnancy. Although several studies have shown an association between maternal subclinical hypothyroidism and/or hypothyroxinemia with obstetric problems and/or neurocognitive impairment in the offspring, there is only limited evidence on the possible positive effects of thyroxine (T4) treatment in such cases. Despite the scarcity of this evidence, there is a widespread agreement among clinicians on the need for treatment of clinical hypothyroidism during pregnancy and the risks that could arise due to therapeutic abstention. As maternal TD is a quite prevalent condition, easily diagnosed and for which an effective and safe treatment is available, some scientific societies have proposed to assess thyroid function during the first trimester of pregnancy and ideally before week 10 of gestational age. Given the physiologic changes of thyroid function during pregnancy, hormone assessment should be performed using trimester-specific reference values ideally based on locally generated data as geographic variations have been detected. Screening of TD should be based on an initial determination of TSH performed early during the first trimester and only if abnormal should it be followed by either a free or total T4measurement. Furthermore, adequate iodine supplementation during pregnancy is critical and if feasible it should be initiated before the woman attempts to conceive.

scholarly journals CATS II Long-term Anthropometric and Metabolic Effects of Maternal Sub-optimal Thyroid Function in Offspring and Mothers

2020 ◽  
Vol 105 (7) ◽  
pp. 2150-2161 ◽  
Author(s):  
Ilaria Muller ◽  
Peter N Taylor ◽  
Rhian M Daniel ◽  
Charlotte Hales ◽  
Anna Scholz ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Fat Mass ◽  
Augmentation Index ◽  
Controlled Trial ◽  
Aortic Pulse Wave Velocity ◽  
Thyroid Stimulating Hormone ◽  
Metabolic Effects ◽  
Long Term Effects ◽  
Thyroid Screening

Abstract Context and Objectives The Controlled Antenatal Thyroid Screening Study I (CATS-I) was a randomized controlled trial investigating the effects of levothyroxine therapy for suboptimal gestational thyroid function (SGTF), comparing outcomes in children of treated (SGTF-T) with untreated (SGTF-U) women during pregnancy. This follow-up study, CATS-II, reports the long-term effects on anthropometric, bone, and cardiometabolic outcomes in mothers and offspring and includes a group with normal gestational thyroid function (NGTF). Design & Participants 332 mothers (197 NGTF, 56 SGTF-U, 79 SGTF-T) aged 41.2±5.3 years (mean±SD) and 326 paired children assessed 9.3±1.0 years after birth for (i) body mass index (BMI); (ii) lean, fat, and bone mass by dual-energy X-ray absorptiometry; (iii) blood pressure, augmentation index, and aortic pulse-wave-velocity; and (iv) thyroid function, lipids, insulin, and adiponectin. The difference between group means was compared using linear regression. Results Offspring’s measurements were similar between groups. Although maternal BMI was similar between groups at CATS-I, after 9 years (at CATS-II) SGTF-U mothers showed higher BMI (median [interquartile ratio] 28.3 [24.6-32.6] kg/m2) compared with NGTF (25.8 [22.9-30.0] kg/m2; P = 0.029), driven by fat mass increase. At CATS-II SGTF-U mothers also had higher thyroid-stimulating hormone (TSH) values (2.45 [1.43-3.50] mU/L) than NGTF (1.54 [1.12-2.07] mU/L; P = 0.015), since 64% had never received levothyroxine. At CATS-II, SGTF-T mothers had BMI (25.8 [23.1-29.8] kg/m2, P = 0.672) and TSH (1.68 [0.89-2.96] mU/L; P = 0.474) values similar to NGTF mothers. Conclusions Levothyroxine supplementation of women with SGTF did not affect long-term offspring anthropometric, bone, and cardiometabolic measurements. However, absence of treatment was associated with sustained long-term increase in BMI and fat mass in women with SGTF.

Thyroid sonomorphology, thyroid peroxidase antibodies and thyroid function

2008 ◽  
Vol 47 (05) ◽  
pp. 194-199 ◽  
Author(s):  
K. Balzer ◽  
J. Diener ◽  
K. Wegscheider ◽  
R. Vaupel ◽  
F. Grünwald ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Nodular Goiter ◽  
Thyroid Peroxidase ◽  
German Population ◽  
Blood Samples ◽  
Thyroid Peroxidase Antibodies ◽  
Thyroid Screening ◽  
Deutschland Gmbh ◽  
Serum Tsh

Summary Aim: Employees of Sanofi-Aventis Deutschland GmbH underwent thyroid screening in 2006 to assess new data about the prevalence of irregular sonomorphological pattern, elevated thyroid peroxidase antibodies (TPO AB) and thyroid function in an unselected adult German population. Participants, methods: The examination included 700 unselected employees. Blood samples were analyzed for serum TSH and TPO AB, and ultrasound of the thyroid was performed. Results: In 40.7% of the participants (n = 285) an irregular sonomorphological pattern was detected: goiter in 13.7%, nodules in 35.6%, nodular goiter in 8.6% and a hypoechogenic pattern of the thyroid gland in 20.4%. Serum TSH was increased in 3.9% and decreased in 0.6%. Elevated TPO AB values were observed in 13%. Only 1.4% (n= 10) showed elevated TPO AB combined with a TSH increase. Sonomorphological abnormalities were associated with increased TPO AB in 7.1%. Elevated TPO AB was observed significantly more often in combination with sonomorphological pathology (54.9%) than without (45.1%) (p = 0.003). Conclusions: Sonomorphological disorders are still very common in Germany and our results are comparable with previous screening examinations. Elevated TPO AB correlated significantly with the sonomorphological pattern of nodules and goiter. This may reflect an improved iodine supply or a hypertrophic stage of autoimmune thyroiditis in some cases.

Effect of maternal thyroid function on neonatal thyroid screening results

2019 ◽  
Author(s):  
M Dolores Ollero ◽  
Juan Pablo Martinez de Esteban ◽  
J Javier Pineda ◽  
Emma Anda ◽  
Marta Toni ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Thyroid Screening ◽  
Maternal Thyroid ◽  
Neonatal Thyroid Screening

Neonatal thyroid screening results are related to gestational maternal thyroid function

2011 ◽  
Vol 75 (3) ◽  
pp. 382-387 ◽  
Author(s):  
S.M.I. Kuppens ◽  
L. Kooistra ◽  
H.A. Wijnen ◽  
H.L. Vader ◽  
T.H.M. Hasaart ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Thyroid Screening ◽  
Maternal Thyroid ◽  
Neonatal Thyroid Screening

scholarly journals Controlled Antenatal Thyroid Screening (CATS) II: long-term cardiometabolic effects of treating maternal sub-optimal thyroid function

2018 ◽  
Author(s):  
Ilaria Muller ◽  
Rhian Daniel ◽  
Charlotte Hales ◽  
Anna Scholz ◽  
Xiaochen Yin ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Thyroid Screening

Thyroid Disease in Pregnancy

2008 ◽  
Vol 04 (01) ◽  
pp. 100
Author(s):  
N Pearce Elizabeth ◽  
M Leung Angela
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Thyroid Function Test ◽  
Autoimmune Thyroid ◽  
Thyroid Screening ◽  
Function Test ◽  
In Pregnancy

The spectrum of thyroid disease in pregnancy has implications for both the mother and the developing fetus. Here we review the interpretation of thyroid function test values, thyrotoxicosis, hypothyroidism, iodine requirements, autoimmune thyroid disease, and thyroid screening recommendations as they pertain to pregnant women. It should be noted that the management of thyroid dysfunction in pregnancy should be closely co-ordinated with obstetricians and other providers.

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