School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom.
Centre for Trials Research, Cardiff University, Cardiff, Wales, United Kingdom.
J Clin Endocrinol Metab. 2018 Apr 1;103(4):1583-1591. doi: 10.1210/jc.2017-02378.
The Controlled Antenatal Thyroid Screening (CATS) study investigated treatment of suboptimal gestational thyroid function (SGTF) on childhood cognition and found no difference in intelligence quotient (IQ) at 3 years between children of treated and untreated SGTF mothers. We have measured IQ in the same children at age 9.5 years and included children from normal gestational thyroid function (normal-GTF) mothers.
DESIGN, SETTING, AND PARTICIPANTS: One examiner, blinded to participant group, assessed children's IQ (Wechsler Intelligence Scale for Children, Fourth Edition UK), long-term memory, and motor function (Developmental Neuropsychological Assessment II) from children of 119 treated and 98 untreated SGTF mothers plus children of 232 mothers with normal-GTF. Logistic regression explored the odds and percentages of an IQ < 85 in the groups.
There was no difference in IQ < 85 between children of mothers with normal-GTF and combined SGTF, i.e., treated and untreated (fully adjusted odds ratio [OR] = 1.15 [95% confidence interval (CI) 0.52, 2.51]; P = 0.731). Furthermore, there was no significant effect of treatment [untreated OR = 1.33 (95% CI 0.53, 3.34); treated OR = 0.75 (95% CI 0.27, 2.06) P = 0.576]. IQ < 85 was 6.03% in normal-GTF, 7.56% in treated, and 11.22% in untreated groups. Analyses accounting for treated-SGTF women with free thyroxine > 97.5th percentile of the entire CATS-I cohort revealed no significant effect on a child's IQ < 85 in CATS-II. IQ at age 3 predicted IQ at age 9.5 (P < 0.0001) and accounted for 45% of the variation.
Maternal thyroxine during pregnancy did not improve child cognition at age 9.5 years. Our findings confirmed CATS-I and suggest that the lack of treatment effect may be a result of the similar proportion of IQ < 85 in children of women with normal-GTF and SGTF.
受控产前甲状腺筛查（CATS）研究调查了对妊娠甲状腺功能不良（SGTF）的治疗对儿童认知的影响，发现治疗与未治疗的 SGTF 母亲的孩子在 3 岁时的智商（IQ）没有差异。我们已经在相同的孩子中测量了 9.5 岁时的智商，并包括了正常妊娠甲状腺功能（正常-GTF）母亲的孩子。
设计、设置和参与者：一名检查者对参与者分组进行了盲法评估，评估了 119 名治疗和 98 名未治疗的 SGTF 母亲的孩子以及 232 名正常-GTF 母亲的孩子的智商（儿童第四版韦氏智力测验，UK）、长期记忆和运动功能（发育神经心理评估 II）。逻辑回归探讨了 IQ<85 的各组的可能性和百分比。
正常-GTF 和合并 SGTF（即治疗和未治疗）的儿童的 IQ<85 之间没有差异，即完全调整后的优势比（OR）=1.15（95%置信区间（CI）0.52，2.51）；P=0.731）。此外，治疗没有显著影响[未治疗的 OR=1.33（95%CI 0.53，3.34）；治疗的 OR=0.75（95%CI 0.27，2.06）；P=0.576]。正常-GTF 组的 IQ<85 为 6.03%，治疗组为 7.56%，未治疗组为 11.22%。对 CATS-I 队列中游离甲状腺素>97.5%百分位数的治疗-SGTF 女性进行分析，发现这对 CATS-II 中儿童的 IQ<85 没有显著影响。3 岁时的智商（IQ）预测 9.5 岁时的智商（IQ）（P<0.0001），并解释了 45%的变异。
妊娠期间母亲的甲状腺素并不能改善儿童 9.5 岁时的认知能力。我们的发现证实了 CATS-I，并表明缺乏治疗效果可能是由于正常-GTF 和 SGTF 母亲的孩子中 IQ<85 的比例相似。
