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Objective: An association between thyroid function during pregnancy or infancy and neurodevelopment in children has been demonstrated. We aimed to investigate whether newborn TSH concentrations are related to subsequent neurocognitive development. Design: We conducted a longitudinal study on 178 children from a general population birth cohort in Granada (Spain) born in [2000][2001][2002]. Methods: TSH concentrations were measured in umbilical cord blood, and cognitive functions were assessed at 4 years of age using the McCarthy's scales of children's abilities (MSCA). Organochlorine (OC) compound concentrations and the combined oestrogenicity (total effective xeno-oestrogenic burden (TEXB)) were also determined in the placentae. Results: Mean newborn TSH was 3.55 mU/l (rangeZ0.24-17 mU/l). In multivariate regression analyses, adjusting for maternal and child characteristics, higher newborn TSH concentrations showed a decrease of 3.51 and 3.15 points on the MSCA general cognitive and executive function scores respectively and were associated with a higher risk of scoring below the 20th percentile (P20) on the quantitative score (odds ratio (OR)Z2.64). Children with TSH in the upper quartile (4.19-17.0 mU/l) were at higher risk of scoring !P20 on span memory (ORZ5.73), whereas children with TSH in the second quartile (2.05-2.95 mU/l) were at lower risk of scoring !P20 on the verbal scale (ORZ0.24). Neonatal TSH status was also associated with general cognitive and executive function outcomes when controlling for prenatal exposure to OCs or placental TEXB. Conclusions: Newborn thyroid hormone status expressed by TSH in cord blood may adversely affect later cognitive function. A more thorough screening for neonatal thyroid deficiency is warranted.

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