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13. Association between maternal thyroid function and risk of gestational hypertension and pre-eclampsia: a systematic review and individual-participant data meta-analysis

Author

Toloza, Freddy J K, Derakhshan, Arash, Männistö, Tuija, Bliddal, Sofie, Popova, Polina V, Carty, David M, Chen, Liangmiao, Taylor, Peter, Mosso, Lorena, Oken, Emily, Suvanto, Eila, Itoh, Sachiko, Kishi, Reiko, Bassols, Judit, Auvinen, Juha, López-Bermejo, Abel, Brown, Suzanne J, Boucai, Laura, Hisada, Aya, Yoshinaga, Jun, Shilova, Ekaterina, Grineva, Elena N, Vrijkotte, Tanja G M, Sunyer, Jordi, Jiménez-Zabala, Ana, Riaño-Galan, Isolina, Lopez-Espinosa, Maria-Jose, Prokop, Larry J, Singh Ospina, Naykky, Brito, Juan P, Rodriguez-Gutierrez, Rene, Alexander, Erik K, Chaker, Layal, Pearce, Elizabeth N, Peeters, Robin P, Feldt-Rasmussen, Ulla, Guxens, Mònica, Chatzi, Leda, Delles, Christian, Roeters van Lennep, Jeanine E, Pop, Victor J M, Lu, Xuemian, Walsh, John P, Nelson, Scott M, Korevaar, Tim I M, and Maraka, Spyridoula

Published
2022
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17. Hypothyroidism

Author

Chaker, Layal, Razvi, Salman, Bensenor, Isabela M., Azizi, Fereidoun, Pearce, Elizabeth N., and Peeters, Robin P.

Published
2022
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23. Association of maternal thyroid function with birthweight: a systematic review and individual-participant data meta-analysis

Author

Derakhshan, Arash, Peeters, Robin P, Taylor, Peter N, Bliddal, Sofie, Carty, David M, Meems, Margreet, Vaidya, Bijay, Chen, Liangmiao, Knight, Bridget A, Ghafoor, Farkhanda, Popova, Polina V, Mosso, Lorena, Oken, Emily, Suvanto, Eila, Hisada, Aya, Yoshinaga, Jun, Brown, Suzanne J, Bassols, Judit, Auvinen, Juha, Bramer, Wichor M, López-Bermejo, Abel, Dayan, Colin M, French, Robert, Boucai, Laura, Vafeiadi, Marina, Grineva, Elena N, Pop, Victor J M, Vrijkotte, Tanja G, Chatzi, Leda, Sunyer, Jordi, Jiménez-Zabala, Ana, Riaño, Isolina, Rebagliato, Marisa, Lu, Xuemian, Pirzada, Amna, Männistö, Tuija, Delles, Christian, Feldt-Rasmussen, Ulla, Alexander, Erik K, Nelson, Scott M, Chaker, Layal, Pearce, Elizabeth N, Guxens, Mònica, Steegers, Eric A P, Walsh, John P, and Korevaar, Tim I M

Published
2020
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25. Neonatal Thyroxine, Maternal Thyroid Function, and Cognition in Mid-childhood in a US Cohort

Author

Lain, Samantha J., Rifas-Shiman, Sheryl L., Pearce, Elizabeth N., Nassar, Natasha, and Oken, Emily

Subjects
Cognitive styles in children -- Physiological aspects -- Research -- Psychological aspects -- Measurement, Thyroxine -- Measurement -- Psychological aspects -- Research, Mothers -- Physiological aspects -- Psychological aspects -- Measurement -- Research, Pediatric research -- Physiological aspects -- Psychological aspects -- Measurement -- Research, Health care industry
Abstract

Objective Examine the associations of maternal thyroid hormones, maternal dietary information, and newborn T.sub.4 levels with cognitive outcomes in mid-childhood. Methods We studied 921 children born 1999-2003 at gestational age [greater than or equal to] 34 weeks, who were participants in Project Viva, a prospective pre-birth cohort study in Massachusetts. We examined maternal dietary information, maternal thyroid hormone levels, and neonatal levels of T.sub.4. Research staff performed cognitive testing in mid-childhood (median age 7.7 years). Results We included 514 women with measured first trimester thyroid hormone concentrations (mean 10.2 weeks); 15% of women had a thyroid stimulating hormone (TSH) level [greater than or equal to] 2.5 mU/L, and 71% were college graduates. Newborn T.sub.4 was collected from 375 infants (mean 17.6 [mu]g/dl; SD 4.0), on day 2 (mean 1.9 days; SD 0.7) as part of the newborn screening program. Mean (SD) verbal and nonverbal IQ, memory, and motor scores of children were 113.2 (14.3), 107.1 (16.7), 17.1 (4.4), and 92.5 (16.6) points, respectively. In multivariable analysis, first trimester maternal thyroid function (total T.sub.3, total T.sub.4, free T.sub.4, thyroid stimulating hormone (TSH) or total thyroid peroxidase (TPO) antibody levels) or newborn T.sub.4 were not associated with any of the cognitive outcomes in mid-childhood after adjustment for sociodemographic and perinatal variables. Conclusions for Practice Maternal or neonatal thyroid hormone levels were not associated with cognitive outcomes in mid-childhood in this population with generally normal thyroid function. As we studied a highly educated cohort residing in an iodine-sufficient area, findings may not be generalizable., Author(s): Samantha J. Lain [sup.1] [sup.4] , Sheryl L. Rifas-Shiman [sup.2] , Elizabeth N. Pearce [sup.3] , Natasha Nassar [sup.1] , Emily Oken [sup.2] Author Affiliations: (1) grid.1013.3, 0000 0004 [...]

Published
2020
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38. Maternal Thyroid Dysfunction During Pregnancy as an Etiologic Factor in Autism Spectrum Disorder: Challenges and Opportunities for Research.

Author

Kaplan, Zoe B., Pearce, Elizabeth N., Lee, Sun Y., Shin, Hyeong-Moo, and Schmidt, Rebecca J.

Subjects
*THYROID diseases, *AUTISM spectrum disorders, *MENTAL illness, *BODY mass index, *HYPOTHYROIDISM, *PREGNANCY outcomes
Abstract

Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition with unknown etiology. Both genetic and environmental factors have been associated with ASD. Environmental exposures during the prenatal period may play an important role in ASD development. This narrative review critically examines the evidence for a relationship between maternal thyroid dysfunction during pregnancy and ASD in the child. Summary: Studies that assessed the associations of hypothyroidism, hyperthyroidism, hypothyroxinemia, thyroid hormone concentrations, or autoimmune thyroid disease with ASD outcomes were included. Most research focused on the relationship between hypothyroidism and ASD. Multiple population-based studies found that maternal hypothyroidism was associated with higher likelihood of an ASD diagnosis in offspring. Associations with other forms of maternal thyroid dysfunction were less consistent. Findings may have been affected by misclassification bias, survival bias, or publication bias. Studies using medical records may have misclassified subclinical thyroid dysfunction as euthyroidism. Two studies that assessed children at early ages may have misclassified those with ASD as typically developing. Most studies adjusted for maternal body mass index (BMI) and/or mental illness, but not interpregnancy interval or pesticide exposure, all factors associated with fetal survival and ASD. Most studies reported a combination of null and statistically significant findings, although publication bias is still possible. Conclusions: Overall, evidence supported a positive association between maternal thyroid dysfunction during pregnancy and ASD outcomes in the child, especially for hypothyroidism. Future studies could reduce misclassification bias by using laboratory measures instead of medical records to ascertain thyroid dysfunction and evaluating children for ASD at an age when it can be reliably detected. Survival bias could be further mitigated by adjusting models for more factors associated with fetal survival and ASD. Additional research is needed to comprehensively understand the roles of maternal levothyroxine treatment, iodine deficiency, or exposure to thyroid-disrupting compounds in the relationship between maternal thyroid dysfunction and child ASD outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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40. Association of Thyroid Function Test Abnormalities and Thyroid Autoimmunity With Preterm Birth: A Systematic Review and Meta-analysis

Author

Korevaar, Tim I. M., Derakhshan, Arash, Taylor, Peter N., Meima, Marcel, Chen, Liangmiao, Bliddal, Sofie, Carty, David M., Meems, Margreet, Vaidya, Bijay, Shields, Beverley, Ghafoor, Farkhanda, Popova, Polina V., Mosso, Lorena, Oken, Emily, Suvanto, Eila, Hisada, Aya, Yoshinaga, Jun, Brown, Suzanne J., Bassols, Judith, Auvinen, Juha, Bramer, Wichor M., López-Bermejo, Abel, Dayan, Colin, Boucai, Laura, Vafeiadi, Marina, Grineva, Elena N., Tkachuck, Alexandra S., Pop, Victor J. M., Vrijkotte, Tanja G., Guxens, Mònica, Chatzi, Leda, Sunyer, Jordi, Jiménez-Zabala, Ana, Riaño, Isolina, Murcia, Mario, Lu, Xuemian, Mukhtar, Shafqat, Delles, Christian, Feldt-Rasmussen, Ulla, Nelson, Scott M., Alexander, Erik K., Chaker, Layal, Männistö, Tuija, Walsh, John P., Pearce, Elizabeth N., Steegers, Eric A. P., and Peeters, Robin P.

Published
2020
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47. Hyperthyroidism: A Review.

Author

Lee, Sun Y. and Pearce, Elizabeth N.

Subjects
*THYROID cancer, *CARDIOVASCULAR diseases, *HYPERTHYROIDISM, *THYROID gland function tests, *NODULAR disease, *IODINE isotopes, *SYMPTOMS
Abstract

Importance: Overt hyperthyroidism, defined as suppressed thyrotropin (previously thyroid-stimulating hormone) and high concentration of triiodothyronine (T3) and/or free thyroxine (FT4), affects approximately 0.2% to 1.4% of people worldwide. Subclinical hyperthyroidism, defined as low concentrations of thyrotropin and normal concentrations of T3 and FT4, affects approximately 0.7% to 1.4% of people worldwide. Untreated hyperthyroidism can cause cardiac arrhythmias, heart failure, osteoporosis, and adverse pregnancy outcomes. It may lead to unintentional weight loss and is associated with increased mortality. Observations: The most common cause of hyperthyroidism is Graves disease, with a global prevalence of 2% in women and 0.5% in men. Other causes of hyperthyroidism and thyrotoxicosis include toxic nodules and the thyrotoxic phase of thyroiditis. Common symptoms of thyrotoxicosis include anxiety, insomnia, palpitations, unintentional weight loss, diarrhea, and heat intolerance. Patients with Graves disease may have a diffusely enlarged thyroid gland, stare, or exophthalmos on examination. Patients with toxic nodules (ie, in which thyroid nodules develop autonomous function) may have symptoms from local compression of structures in the neck by the thyroid gland, such as dysphagia, orthopnea, or voice changes. Etiology can typically be established based on clinical presentation, thyroid function tests, and thyrotropin-receptor antibody status. Thyroid scintigraphy is recommended if thyroid nodules are present or the etiology is unclear. Thyrotoxicosis from thyroiditis may be observed if symptomatic or treated with supportive care. Treatment options for overt hyperthyroidism from autonomous thyroid nodules or Graves disease include antithyroid drugs, radioactive iodine ablation, and surgery. Treatment for subclinical hyperthyroidism is recommended for patients at highest risk of osteoporosis and cardiovascular disease, such as those older than 65 years or with persistent serum thyrotropin level less than 0.1 mIU/L. Conclusions and Relevance: Hyperthyroidism affects 2.5% of adults worldwide and is associated with osteoporosis, heart disease, and increased mortality. First-line treatments are antithyroid drugs, thyroid surgery, and radioactive iodine treatment. Treatment choices should be individualized and patient centered. This review summarizes current evidence regarding the pathophysiology, clinical presentation, and treatment of hyperthyroidism, focusing on the management of Graves disease and toxic nodular disease. [ABSTRACT FROM AUTHOR]

Published
2023
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