Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University (AHMU), 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. 2024 Jul;34(7):899-911. doi: 10.1089/thy.2023.0612. Epub 2024 Jun 7.
An association between maternal thyroid dysfunction throughout pregnancy and the subsequent risk of neurodevelopmental abnormalities in offspring has been demonstrated. However, the potential effects of maternal thyroid autoimmunity on neurodevelopment in the absence of maternal hypothyroidism remain unclear. Therefore, in this study, we explored the association between maternal thyroid peroxidase antibody (TPOAb) positivity and cognitive development in preschool children. A total of 1849 mother-child pairs were recruited from the Ma'anshan Birth Cohort (MABC) Study. During the follow-up period, an electrochemiluminescence immunoassay was used to retrospectively measure serum TPOAb levels in pregnant women. The cognitive development of preschool children was evaluated by using the Chinese version of the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition (WPPSI-IV). A growth mixture model was used to fit the trajectory of TPOAb. Multiple linear regression and logistic regression models were used to explore the associations between the developmental trajectory of TPOAb-positivity at different gestational periods and the cognitive development of preschool children by sex. A total of 1849 mother-child pairs (mean [SD] age: 26.7 [3.6] years) were enrolled in the final study. Maternal TPOAb positivity in the first trimester was associated with a risk of below-average processing speed index in girls (OR: 2.07; 95% CI 1.06 to 4.01) and below-average full-scale intelligence quotient (FSIQ) in boys (OR: 2.36; 95% CI: 1.10 to 5.05). Maternal TPOAb positivity in the third trimester (T3) was associated with below-average working memory index (WMI) (OR: 2.51; 95% CI: 1.02 to 6.20) in girls. In girls, the WMI (β = -3.17, 95% CI: -5.82 to -0.52), fluid reasoning index (FRI) (β = -4.49, 95% CI: -7.18 to -1.80), and FSIQ score (β = -2.43, 95% CI: -4.77 to -0.08) decreased, whereas in mothers, the level of log-transformed thyroid peroxidase antibody (lgTPOAb) increased during pregnancy. Positive maternal TPOAb levels during pregnancy may be associated with poorer cognitive development in preschool children. These findings require independent confirmation in other populations.
已有研究表明，孕妇甲状腺功能障碍与后代神经发育异常的风险之间存在关联。然而，在不存在母体甲状腺功能减退的情况下，母体自身免疫性甲状腺疾病对神经发育的潜在影响尚不清楚。因此，本研究旨在探讨孕妇甲状腺过氧化物酶抗体（TPOAb）阳性与学龄前儿童认知发育之间的关系。
我们从马鞍山出生队列（MABC）研究中招募了 1849 对母婴。在随访期间，使用电化学发光免疫分析法检测孕妇血清 TPOAb 水平。采用韦氏学龄前及小学儿童智力量表第四版（WPPSI-IV）中文版评估学龄前儿童的认知发育。采用增长混合模型拟合 TPOAb 的轨迹。采用多元线性回归和逻辑回归模型，按性别探讨不同孕期 TPOAb 阳性发展轨迹与学龄前儿童认知发育之间的关系。
最终共有 1849 对母婴（平均[标准差]年龄：26.7[3.6]岁）纳入本研究。孕早期 TPOAb 阳性与女孩的加工速度指数低于平均水平（OR：2.07；95%CI 1.06 至 4.01）和男孩的全智商（FSIQ）低于平均水平（OR：2.36；95%CI：1.10 至 5.05）相关。孕晚期（T3）TPOAb 阳性与女孩的工作记忆指数（WMI）低于平均水平（OR：2.51；95%CI：1.02 至 6.20）相关。在女孩中，WMI（β=-3.17，95%CI：-5.82 至-0.52）、流体推理指数（FRI）（β=-4.49，95%CI：-7.18 至-1.80）和 FSIQ 评分（β=-2.43，95%CI：-4.77 至-0.08）下降，而母亲在怀孕期间的 TPOAb 水平呈对数增加。
妊娠期间 TPOAb 阳性可能与学龄前儿童认知发育较差有关。这些发现需要在其他人群中进行独立验证。
