Downstream Effects of Maternal Hypothyroxinemia in Early Pregnancy: Nonverbal IQ and Brain Morphology in School-Age Children
Downstream Effects of Maternal Hypothyroxinemia in Early Pregnancy: Nonverbal IQ and Brain Morphology in School-Age Children
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DOI：
10.1210/jc.2013-4281
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发表时间：
2014-07-01
影响因子：
5.8
通讯作者：
White, Tonya
中科院分区：
文献类型：
--
作者：
Ghassabian, Akhgar;El Marroun, Hanan;White, Tonya
内容：虽然产妇低甲状腺素血症被认为是与儿童的神经发育中的各种不良后果，基本的神经生物学是在很大程度上unknown.Objective：本研究的目的是探讨产妇低甲状腺素血症在怀孕早期和儿童的非语言智商（IQ）之间的关系。此外，我们还探讨了出生前暴露于低甲状腺素血症的儿童和健康对照组之间的全脑体积、皮质厚度和脑表面积是否存在差异。设计和设置：该研究包括荷兰一个大型的基于人群的前瞻性出生队列。参与者：共有3727对母亲和孩子参加了这项研究，这些母亲和孩子在怀孕不到18周时就有产前甲状腺功能的数据，在6岁时有非语言智商的数据。在652名儿童，脑成像进行了8岁。主要措施：产妇低甲状腺素血症被定义为游离T4在最低的5%的样品，而TSH是在正常范围内。在6岁时，使用荷兰测试电池评估儿童的智商。使用高分辨率结构磁共振成像评估全球脑体积测量、皮质厚度和表面积。结果：妊娠早期甲状腺功能低下母亲的孩子智商比甲状腺功能正常母亲的孩子低4.3分（95%置信区间-6.68，-1.81; P = .001）。调整后的多重测试，我们没有发现任何差异，在脑容量的措施，皮质厚度，和表面积之间的儿童产前暴露于低甲状腺素血症和controls.Conclusions：我们的研究结果证实了母亲的低甲状腺素血症对儿童的非语言智商在学龄期的大的不利影响。然而，我们没有发现任何证据表明母亲的低甲状腺素血症与学龄儿童的脑形态学差异有关。
Context: Although maternal hypothyroxinemia is suggested to be related to various adverse consequences in a child's neurodevelopment, the underlying neurobiology is largely unknown.Objective: The objective of the study was to examine the relationship between maternal hypothyroxinemia in early pregnancy and children's nonverbal intelligence quotient (IQ). Furthermore, we explored whether global brain volumes, cortical thickness, and brain surface area differed between children exposed prenatally to hypothyroxinemia and healthy controls.Design and Setting: The study included a large population-based prospective birth cohort in The Netherlands.Participants: A total of 3727 mother-child pairs with data on prenatal thyroid function at less than 18 weeks of gestation and nonverbal IQ at 6 years participated in the study. In 652 children, brain imaging was performed at 8 years of age.Main Measures: Maternal hypothyroxinemia was defined as free T4 in the lowest 5% of the sample, whereas TSH was in the normal range. At 6 years, children's IQ was assessed using a Dutch test battery. Global brain volumetric measures, cortical thickness, and surface area were assessed using high-resolution structural magnetic resonance imaging.Results: The children of mothers with hypothyroxinemia in early pregnancy scored 4.3 points IQ lower than the children of mothers with normal thyroid status (95% confidence interval -6.68, -1.81; P = .001). After adjustment for multiple testing, we did not find any differences in brain volumetric measures, cortical thickness, and surface area between children exposed prenatally to hypothyroxinemia and controls.Conclusions: Our findings confirm a large adverse effect of maternal hypothyroxinemia on children's nonverbal IQ at school age. However, we found no evidence that maternal hypothyroxinemia is associated with differences in brain morphology in school-age children.