Neonatal Thyroxine, Maternal Thyroid Function, and Cognition in Mid-childhood in a US Cohort

• Published in: Maternal and child health journal 2020-04, Vol.24 (4), p.503-513
• Main Authors: Lain, Samantha J., Rifas-Shiman, Sheryl L., Pearce, Elizabeth N., Nassar, Natasha, Oken, Emily
• Format: Article
• Language: English
• Subjects: Age; Babies; Child; Child Development; Childhood; Children & youth; Childrens health; Cognition & reasoning; Cognition - physiology; Cognitive styles in children; Cohort Studies; Female; Gynecology; Hormones; Humans; Infant; Infant, Newborn; Iodine; Male; Massachusetts; Maternal & child health; Maternal and Child Health; Measurement; Medical screening; Medicine; Medicine & Public Health; Mothers; Newborn babies; Pediatric research; Pediatrics; Physiological aspects; Population; Population Economics; Pregnancy; Prospective Studies; Psychological aspects; Public Health; Sociology; Studies; Thyroid; Thyroid Function Tests - methods; Thyroid Function Tests - statistics & numerical data; Thyroid gland; Thyroxine; Thyroxine - analysis; Thyroxine - blood; United States; Womens health
• ISSN: 1092-7875; 1573-6628
• DOI: 10.1007/s10995-019-02867-5

Objective Examine the associations of maternal thyroid hormones, maternal dietary information, and newborn T 4 levels with cognitive outcomes in mid-childhood. Methods We studied 921 children born 1999–2003 at gestational age ≥ 34 weeks, who were participants in Project Viva, a prospective pre-birth cohort study in Massachusetts. We examined maternal dietary information, maternal thyroid hormone levels, and neonatal levels of T 4 . Research staff performed cognitive testing in mid-childhood (median age 7.7 years). Results We included 514 women with measured first trimester thyroid hormone concentrations (mean 10.2 weeks); 15% of women had a thyroid stimulating hormone (TSH) level ≥ 2.5 mU/L, and 71% were college graduates. Newborn T 4 was collected from 375 infants (mean 17.6 μg/dl; SD 4.0), on day 2 (mean 1.9 days; SD 0.7) as part of the newborn screening program. Mean (SD) verbal and nonverbal IQ, memory, and motor scores of children were 113.2 (14.3), 107.1 (16.7), 17.1 (4.4), and 92.5 (16.6) points, respectively. In multivariable analysis, first trimester maternal thyroid function (total T 3 , total T 4 , free T 4 , thyroid stimulating hormone (TSH) or total thyroid peroxidase (TPO) antibody levels) or newborn T 4 were not associated with any of the cognitive outcomes in mid-childhood after adjustment for sociodemographic and perinatal variables. Conclusions for Practice Maternal or neonatal thyroid hormone levels were not associated with cognitive outcomes in mid-childhood in this population with generally normal thyroid function. As we studied a highly educated cohort residing in an iodine-sufficient area, findings may not be generalizable.