Arash Derakhshan1,2, Tim I M Korevaar1,2, Peter N Taylor3, Deborah Levie1,2,4, Monica Guxens4,5,6, Vincent W V Jaddoe2,7, Scott M Nelson8, Henning Tiemeier9,10, Robin P Peeters1,2. 1. Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus MC, Rotterdam, Netherlands. 2. The Generation R Study Group, Erasmus MC, Rotterdam, Netherlands. 3. Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff, United Kingdom. 4. ISGlobal, Centre for Research in Environmental Epidemiology, Barcelona, Spain. 5. Pompeu Fabra University, Barcelona, Spain. 6. Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain. 7. Department of Pediatrics, Erasmus MC, Rotterdam, the Netherlands. 8. School of Medicine, University of Glasgow, Glasgow, United Kingdom. 9. Department of Child and Adolescent Psychiatry, Erasmus MC, Rotterdam, Netherlands. 10. Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands.
Abstract
Context: Thyroperoxidase antibody (TPOAb) positivity is a major risk factor for gestational thyroid dysfunction. During the first 18 to 20 weeks of pregnancy, high concentrations of human chorionic gonadotropin (hCG) stimulate the thyroid to ensure adequate thyroid hormone availability for the developing fetus. However, TPOAb-positive women have an impaired thyroidal response to hCG stimulation. Objective: To study the association of maternal TPOAb positivity during pregnancy with child IQ. Design, Setting, and Participants: This study was embedded in two prospective birth cohorts: Generation R (Rotterdam, the Netherlands) and Avon Longitudinal Study of Parents and Children (ALSPAC; United Kingdom). Mother-child pairs with available data on early pregnancy TPOAb (≤18 weeks of gestation) and offspring IQ were included (n = 3637 for Generation R and n = 2396 for ALSPAC). Main Outcome Measures: Child IQ at 5 to 10 years of age. Results: In Generation R, TPOAb positivity was associated with a 2.0 ± 0.9-point lower mean child IQ (P = 0.03). Sensitivity analyses showed negative effect estimates already from TPOAb concentrations considerably lower than currently used manufacturer cutoffs. In ALSPAC, neither TPOAb positivity nor TPOAb concentrations below manufacturer cutoffs were associated with child IQ (TPOAb positivity: 0.7 ± 1.0; P = 0.45). Adjustment for maternal TSH or free T4 concentrations or urinary iodine/creatinine ratio did not change the results. Conclusion: TPOAb positivity during pregnancy was associated with lower child IQ in Generation R but not in ALSPAC. Further studies are needed to elucidate whether differences between the study populations, such as maternal iodine status, could be the underlying cause for these differences.
Context:Thyroperoxidase antibody (TPOAb) positivity is a major risk factor for gestational thyroid dysfunction. During the first 18 to 20 weeks of pregnancy, high concentrations of human chorionic gonadotropin (hCG) stimulate the thyroid to ensure adequate thyroid hormone availability for the developing fetus. However, TPOAb-positive women have an impaired thyroidal response to hCG stimulation. Objective: To study the association of maternal TPOAb positivity during pregnancy with child IQ. Design, Setting, and Participants: This study was embedded in two prospective birth cohorts: Generation R (Rotterdam, the Netherlands) and Avon Longitudinal Study of Parents and Children (ALSPAC; United Kingdom). Mother-child pairs with available data on early pregnancy TPOAb (≤18 weeks of gestation) and offspring IQ were included (n = 3637 for Generation R and n = 2396 for ALSPAC). Main Outcome Measures: Child IQ at 5 to 10 years of age. Results: In Generation R, TPOAb positivity was associated with a 2.0 ± 0.9-point lower mean child IQ (P = 0.03). Sensitivity analyses showed negative effect estimates already from TPOAb concentrations considerably lower than currently used manufacturer cutoffs. In ALSPAC, neither TPOAb positivity nor TPOAb concentrations below manufacturer cutoffs were associated with child IQ (TPOAb positivity: 0.7 ± 1.0; P = 0.45). Adjustment for maternal TSH or free T4 concentrations or urinary iodine/creatinine ratio did not change the results. Conclusion: TPOAb positivity during pregnancy was associated with lower child IQ in Generation R but not in ALSPAC. Further studies are needed to elucidate whether differences between the study populations, such as maternal iodine status, could be the underlying cause for these differences.
Authors: J Sun; D Teng; C Li; S Peng; J Mao; W Wang; X Xie; C Fan; C Li; T Meng; S Zhang; J Du; Z Gao; Z Shan; W Teng Journal: J Endocrinol Invest Date: 2019-07-01 Impact factor: 4.256
Authors: Akhgar Ghassabian; Livia Pierotti; Mikel Basterrechea; Leda Chatzi; Marisa Estarlich; Ana Fernández-Somoano; Abby F Fleisch; Diane R Gold; Jordi Julvez; Polyxeni Karakosta; Aitana Lertxundi; Maria-Jose Lopez-Espinosa; Tessa A Mulder; Tim I M Korevaar; Emily Oken; Robin P Peeters; Sheryl Rifas-Shiman; Euripides Stephanou; Adonina Tardón; Henning Tiemeier; Martine Vrijheid; Tanja G M Vrijkotte; Jordi Sunyer; Mònica Guxens Journal: JAMA Netw Open Date: 2019-10-02