Chen Zhang1, Xi Yang1, Yong Zhang1,2, Fei Guo1, Shuai Yang1, Robin P Peeters3, Tim I M Korevaar3, Jianxia Fan1,2,4,5, He-Feng Huang1,2,4,5. 1. International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. 2. Institute of Embryo-Fetal Original Adult Disease Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China. 3. Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, GE Rotterdam, Netherlands. 4. Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China. 5. Shanghai Municipal Key Clinical Specialty, Shanghai, China.
Abstract
CONTEXT: Previous studies suggest that maternal thyroid function affects fetal growth, but the association between combined thyroid hormones from early to late pregnancy and newborn birth weight remains unknown. OBJECTIVE: To explore the association of maternal thyroid function during early and late pregnancy with birth weight. DESIGN: A large prospective cohort study of a Chinese population. SETTING: This study recruited pregnant women who underwent first-trimester prenatal screenings at the International Peace Maternity and Child Health Hospital between January 2013 and December 2016. PARTICIPANTS: This study enrolled 46,186 mothers in whom TSH, free thyroxine (FT4), T3, and thyroid peroxidase antibody concentrations were measured in the first and third trimesters and in whom data on birth weight were available. MAIN OUTCOME MEASURES: Birth weight, small for gestational age, large for gestational age (LGA). RESULTS: A higher TSH or FT4 concentration, or a lower T3 concentration, during the first or third trimester was associated with a lower birth weight. The lowest percentiles of maternal FT4 (FT4 < 2.5th percentile) in both trimesters were associated with a 0.34-SD higher birth weight. The effect estimates were greater in those in the first trimester (0.23 SD) or in the third trimester (0.17 SD). The association of maternal TSH and FT4 with birth weight differed according to fetal sex. CONCLUSIONS: Persistently low FT4 concentrations throughout pregnancy were associated with higher birth weight and an increased risk of LGA. Based on these findings, we recommend monitoring mildly altered concentrations of thyroid hormone throughout pregnancy.
CONTEXT: Previous studies suggest that maternal thyroid function affects fetal growth, but the association between combined thyroid hormones from early to late pregnancy and newborn birth weight remains unknown. OBJECTIVE: To explore the association of maternal thyroid function during early and late pregnancy with birth weight. DESIGN: A large prospective cohort study of a Chinese population. SETTING: This study recruited pregnant women who underwent first-trimester prenatal screenings at the International Peace Maternity and Child Health Hospital between January 2013 and December 2016. PARTICIPANTS: This study enrolled 46,186 mothers in whom TSH, free thyroxine (FT4), T3, and thyroid peroxidase antibody concentrations were measured in the first and third trimesters and in whom data on birth weight were available. MAIN OUTCOME MEASURES: Birth weight, small for gestational age, large for gestational age (LGA). RESULTS: A higher TSH or FT4 concentration, or a lower T3 concentration, during the first or third trimester was associated with a lower birth weight. The lowest percentiles of maternal FT4 (FT4 < 2.5th percentile) in both trimesters were associated with a 0.34-SD higher birth weight. The effect estimates were greater in those in the first trimester (0.23 SD) or in the third trimester (0.17 SD). The association of maternal TSH and FT4 with birth weight differed according to fetal sex. CONCLUSIONS: Persistently low FT4 concentrations throughout pregnancy were associated with higher birth weight and an increased risk of LGA. Based on these findings, we recommend monitoring mildly altered concentrations of thyroid hormone throughout pregnancy.
Authors: Arash Derakhshan; Robin P Peeters; Peter N Taylor; Sofie Bliddal; David M Carty; Margreet Meems; Bijay Vaidya; Liangmiao Chen; Bridget A Knight; Farkhanda Ghafoor; Polina V Popova; Lorena Mosso; Emily Oken; Eila Suvanto; Aya Hisada; Jun Yoshinaga; Suzanne J Brown; Judit Bassols; Juha Auvinen; Wichor M Bramer; Abel López-Bermejo; Colin M Dayan; Robert French; Laura Boucai; Marina Vafeiadi; Elena N Grineva; Victor J M Pop; Tanja G Vrijkotte; Leda Chatzi; Jordi Sunyer; Ana Jiménez-Zabala; Isolina Riaño; Marisa Rebagliato; Xuemian Lu; Amna Pirzada; Tuija Männistö; Christian Delles; Ulla Feldt-Rasmussen; Erik K Alexander; Scott M Nelson; Layal Chaker; Elizabeth N Pearce; Mònica Guxens; Eric A P Steegers; John P Walsh; Tim I M Korevaar Journal: Lancet Diabetes Endocrinol Date: 2020-06 Impact factor: 44.867
Authors: Xi Bai; Zhibo Zhou; Mingliang Su; Yansheng Li; Liuqing Yang; Kejia Liu; Hongbo Yang; Huijuan Zhu; Shi Chen; Hui Pan Journal: Front Public Health Date: 2022-08-08