Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle, Anhui Medical University (AHMU), Ministry of Education of the People's Republic of China, NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China.
Ma'anshan Maternal and Child Health Center (MCHC), Ma'anshan, China.
Thyroid. 2022 Oct;32(10):1229-1242. doi: 10.1089/thy.2022.0044. Epub 2022 Aug 30.
Epidemiological and experimental studies suggest that thyroid peroxidase antibody (TPOAb)- and thyroglobulin antibody (TGAb)-positive exposure during gestation may contribute to offspring's adverse neural development. However, limited knowledge is available on the association between joint exposure on TPOAb and TGAb and children's emotional and behavioral development. Furthermore, the sex-specific effect on the developmental process of preschoolers' emotions and behaviors is unknown. The present research intends to examine the sex-specific effect of TPOAb- and TGAb-positive exposure in gestation on the developmental process of preschoolers' emotions and behaviors. A total of 2455 mother-child pairs were included from the Ma'anshan Birth Cohort study. The serum TPOAb and TGAb of pregnant women was measured retrospectively by electrochemical immunoassay during the follow-up period. Preschoolers' emotional and behavioral development was assessed by a child behavior checklist 1.5-5. Growth mixture modeling was adopted to fit thyroid antibody (TAb) trajectories. Poisson regression models were used, stratifying by sex, to examine the association between TAb trajectories, as well as four categories of maternal TAb exposure and preschoolers' emotional and behavioral problems. Boys born to mothers with TPOAb positivity in the first, second, and third trimesters of pregnancy had an increased risk of autism spectrum problems after adjusting for confounders, with relative risk (RR) [confidence interval, CI] of 2.01 [1.24-3.27], 2.15 [1.08-4.26], and 2.13 [1.20-3.79], respectively. Maternal TGAb positivity and TPOAb negativity in the first trimester were associated with a high risk of attention-deficit/hyperactivity problems in boys (RR = 1.74 [CI 1.01-2.99]). The prevalence of depressive problems in girls was 33.3% after exposure to TPOAb alone in the third trimester of pregnancy. Exposure to TPOAb alone in the third trimester of pregnancy was associated with an increased risk of depressive problems in girls (RR = 1.78 [CI 1.09-2.90]). Maternal TPOAb positivity in all three trimesters was associated with the risk of autism spectrum problems in boys. Isolated maternal TGAb positivity in the first trimester was associated with attention-deficit/hyperactivity problems in boys, whereas isolated maternal TPOAb positivity in the third trimester was associated with depressive problems in girls.
流行病学和实验研究表明，妊娠期间甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体（TGAb）阳性暴露可能导致后代神经发育不良。然而，关于 TPOAb 和 TGAb 联合暴露与儿童情绪和行为发育之间的关系，我们知之甚少。此外，关于 TPOAb 和 TGAb 阳性暴露对学龄前儿童情绪和行为发育过程的性别特异性影响，我们也知之甚少。本研究旨在探讨妊娠期间 TPOAb 和 TGAb 阳性暴露对学龄前儿童情绪和行为发育过程的性别特异性影响。
共有 2455 对母婴来自马鞍山出生队列研究。在随访期间，通过电化学免疫分析法回顾性测量孕妇血清 TPOAb 和 TGAb。采用儿童行为检查表 1.5-5 评估学龄前儿童的情绪和行为发育。采用增长混合模型拟合甲状腺抗体（TAb）轨迹。采用泊松回归模型，按性别分层，研究 TAb 轨迹以及母亲 TAb 暴露的四个类别与学龄前儿童情绪和行为问题之间的关系。
调整混杂因素后，在妊娠前三个月、第二个三个月和第三个三个月 TPOAb 阳性的男孩，自闭症谱系问题的风险增加，相对风险（RR）[置信区间，CI]为 2.01 [1.24-3.27]、2.15 [1.08-4.26]和 2.13 [1.20-3.79]。母亲在妊娠第一个三个月 TGAb 阳性和 TPOAb 阴性与男孩注意力缺陷/多动障碍问题的高风险相关（RR=1.74 [CI 1.01-2.99]）。仅在妊娠第三个三个月暴露于 TPOAb 的女孩中，抑郁问题的患病率为 33.3%。妊娠第三个三个月仅暴露于 TPOAb 与女孩抑郁问题的风险增加相关（RR=1.78 [CI 1.09-2.90]）。
在所有三个三个月中，母亲 TPOAb 阳性与男孩自闭症谱系问题的风险相关。妊娠第一个三个月单纯母亲 TGAb 阳性与男孩注意力缺陷/多动障碍问题相关，而妊娠第三个三个月单纯母亲 TPOAb 阳性与女孩抑郁问题相关。
