Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
Eur Thyroid J. 2024 May 31;13(3). doi: 10.1530/ETJ-23-0233. Print 2024 Jun 1.
Maternal thyroid autoimmunity and thyroid function in early pregnancy may impact fetal neurodevelopment. We aimed to investigate how thyroid autoimmunity and thyroid function in early pregnancy were associated with language acquisition in offspring at 12-36 months of age.
This study was embedded in the prospective Odense child cohort. Mother-child dyads were excluded in case of maternal intake of thyroid medication during pregnancy. The parents completed MacArthur-Bates Communicative Development Inventories (MB-CDI) every third month to assess their offspring's productive vocabulary. All completed reports for each child were included in the analyses. Logistic growth curve models evaluated associations between MB-CDI scores and levels of maternal thyroid peroxidase antibodies (TPOAb), free thyroxine (FT4), and thyrotropin, respectively, measured in early pregnancy (median gestational week 12). All models were stratified by offspring sex and adjusted for maternal age, education, pre-pregnancy body mass index, parity, breastfeeding, and offspring age.
The study included 735 mother-child dyads. Children born to mothers with TPOAb ≥11 kIU/L, opposed to TPOAb <11 kIU/L, had a lower probability of producing words at age 18-36 months for girls (OR = 0.78, P < 0.001) and 33-36 months for boys (OR = 0.83, P < 0.001). The probability of producing words was higher in girls at 30-36 months of age with low-normal maternal FT4 vs high-normal FT4 (OR = 0.60, P < 0.001), and a similar trend was seen in boys. Results were ambiguous for thyrotropin.
In women without known thyroid disease, TPOAb positivity in early pregnancy was negatively associated with productive vocabulary acquisition in girls and boys. This association was not mediated by a decreased thyroid function, as low-normal maternal FT4, unexpectedly, indicated better vocabulary acquisition. Our results support that maternal thyroid autoimmunity per se may affect fetal neurodevelopment.
孕妇妊娠早期的甲状腺自身免疫和甲状腺功能可能会影响胎儿的神经发育。我们旨在研究妊娠早期的甲状腺自身免疫和甲状腺功能如何与 12-36 个月大的子女的语言习得相关。
本研究嵌入前瞻性的奥登塞儿童队列研究中。在孕妇怀孕期间服用甲状腺药物的情况下，排除母婴对子。父母每三个月完成一次麦克阿瑟-贝茨交际发展量表（MB-CDI），以评估其子女的生产词汇量。所有为每个孩子完成的报告都包含在分析中。逻辑增长曲线模型评估了 MB-CDI 评分与妊娠早期（中位妊娠 12 周）测量的母体甲状腺过氧化物酶抗体（TPOAb）、游离甲状腺素（FT4）和促甲状腺激素水平之间的关系。所有模型均按子女性别分层，并根据母亲年龄、教育程度、孕前体重指数、产次、母乳喂养和子女年龄进行调整。
本研究纳入了 735 对母婴对子。与 TPOAb <11 kIU/L 的母亲相比，TPOAb ≥11 kIU/L 的母亲所生的女孩在 18-36 个月时产生单词的可能性较低（OR=0.78，P<0.001），男孩在 33-36 个月时产生单词的可能性较低（OR=0.83，P<0.001）。对于女孩，在 30-36 个月时，低正常的母体 FT4 与高正常的 FT4 相比，产生单词的可能性更高（OR=0.60，P<0.001），男孩也出现了类似的趋势。促甲状腺激素的结果则不确定。
在没有已知甲状腺疾病的女性中，妊娠早期 TPOAb 阳性与女孩和男孩的生产词汇习得能力下降相关。这种关联不是由甲状腺功能减退引起的，因为出乎意料的是，低正常的母体 FT4 表明词汇习得更好。我们的研究结果表明，母体甲状腺自身免疫本身可能会影响胎儿的神经发育。
