Charlotte Hales 1 , Peter N Taylor 1 , Sue Channon 2 , Kirsten McEwan 2 , Anita Thapar 3 , Kate Langley 4 , Ilaria Muller 1 , Mohd S Draman 1 , Colin Dayan 1 , John W Gregory 1 , Onyebuchi Okosieme 1 , John H Lazarus 1 , D Aled Rees 5 , Marian Ludgate 1 Show Affiliations »
Abstract
Show RCT »
Hide RCT «
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. © Endocrine Society 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
RCT Entities: Population
Interventions
Outcomes
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. © Endocrine Society 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Entities: Chemical
Disease
Species
Keywords:
ADHD; autism; childhood; pregnancy; thyroid; thyroxine
Mesh： See more »
Substances： See more »
Year: 2020
PMID： 31665323 DOI： 10.1210/clinem/dgz098
Source DB: PubMed Journal: J Clin Endocrinol Metab ISSN： 0021-972X Impact factor: 5.958