Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark.
Department of Clinical Biochemistry, Viborg Regional Hospital, Viborg, Denmark.
Clin Endocrinol (Oxf). 2021 Mar;94(3):484-493. doi: 10.1111/cen.14314. Epub 2020 Sep 15.
Thyroid hormones are crucial developmental factors, and thyroid disease in pregnant women is a concern. Overweight and obesity are also important health concerns, and we hypothesized that in utero exposure to maternal thyroid disease could programme the foetus to development of adiposity.
Cohort and case-cohort studies.
Pregnant women from the Danish National Birth Cohort and their 7-year-old children.
Maternal thyroid disease (hyperthyroidism and hypothyroidism) was assessed from registrations of diagnoses and treatment (n = 71 706) or from the measurement of thyroid-stimulating hormone (TSH) in a stored blood sample from the early pregnancy (n = 7624). Maternal prepregnancy body mass index (BMI) and child BMI at 7 years of age were used to define overweight and obesity, and associations were evaluated using regression models adjusting for potential confounders.
No association was found between maternal thyroid disease in pregnancy and child overweight (hyperthyroidism: adjusted risk ratio (aRR): 1.02 (95% confidence interval (CI): 0.58-1.82); hypothyroidism: 1.31 (0.86-1.97)) or obesity (hyperthyroidism: 0.96 (0.53-1.75); hypothyroidism: 1.25 (0.76-2.05)). On the other hand, pregnant women with hypothyroidism in early pregnancy had a higher risk of being overweight (aRR: 1.20 (95% CI: 1.03; 1.41)) and obese (1.45 (1.07; 1.96)), whereas women with hyperthyroidism had a lower risk of being overweight (0.79 (0.64; 0.98)).
Results provide no evidence that maternal thyroid disease in pregnancy programmes adiposity in the child, but corroborate an association between maternal thyroid disease and adiposity in the mother.
甲状腺激素是至关重要的发育因素,孕妇甲状腺疾病是一个关注点。超重和肥胖也是重要的健康关注点,我们假设孕妇在子宫内接触甲状腺疾病可能会导致胎儿发育为肥胖。
队列和病例-对照研究。
丹麦国家出生队列的孕妇及其 7 岁的孩子。
从诊断和治疗的登记(n=71706)或从早期妊娠的储存血样中测量甲状腺刺激激素(TSH)(n=7624)评估母亲的甲状腺疾病(甲状腺功能亢进和甲状腺功能减退)。母亲孕前体重指数(BMI)和孩子 7 岁时的 BMI 用于定义超重和肥胖,并使用回归模型进行评估,调整了潜在混杂因素。
妊娠期间母亲的甲状腺疾病与儿童超重(甲状腺功能亢进:调整后的风险比(aRR):1.02(95%置信区间(CI):0.58-1.82);甲状腺功能减退:1.31(0.86-1.97))或肥胖(甲状腺功能亢进:0.96(0.53-1.75);甲状腺功能减退:1.25(0.76-2.05))之间没有关联。另一方面,患有早期妊娠甲状腺功能减退的孕妇超重(aRR:1.20(95%CI:1.03;1.41))和肥胖(1.45(1.07;1.96))的风险较高,而患有甲状腺功能亢进的孕妇超重(0.79(0.64;0.98))的风险较低。
结果没有提供证据表明孕妇在怀孕期间的甲状腺疾病会导致儿童肥胖,但证实了母亲甲状腺疾病与母亲肥胖之间的关联。