Maternal overt hypothyroidism and neurobehavioral outcome of neonates: A cohort study from an iodine-deficient area of Northern India

Ganaie, Mohammad Ashraf; Charoo, Bashir Ahmed; Sofi, Riyaz Ahmad; Ahmed, Asif; Bhat, Javeed I.

doi:10.1007/s13312-015-0733-8

Cited by 6 publications

(6 citation statements)

References 9 publications

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“…Five studies presenting regression analyses were excluded because they did not provide regression information in a form that would allow straightforward conversion into odds ratios: for example, 2 studies provided linear regression results with continuous not binary predictors. A further 8 articles were excluded from the meta‐analysis for the following reasons: sibling papers with no additional data (n = 2), lacking numerical data (n = 1), using a novel outcome measure that was not validated or suitable for meta‐analysis (n = 1), reporting odds ratios (using logistic regression) but using continuous predictors (n = 1) and reporting psychomotor outcomes only (n = 3) . Details on why studies were excluded from the meta‐analysis are shown in Table S5.…”

Section: Resultsmentioning

confidence: 99%

“…In total, 39 original articles were found to be eligible for this systematic review, with 37 observational studies and 2 RCTs (Table S1). Overall 909 176 people participated in these studies (857 014 of them being from one study).…”

Section: Resultsmentioning

confidence: 99%

“…A further 8 articles were excluded from the meta-analysis for the following reasons: sibling papers with no additional data (n = 2), 21,51 lacking numerical data (n = 1), 44 using a novel outcome measure that was not validated or suitable for meta-analysis (n = 1), 34 reporting odds ratios (using logistic regression) but using continuous predictors (n = 1) 39 and reporting psychomotor outcomes only (n = 3). 19,24,42 Details on why studies were excluded from the meta-analysis are shown in Table S5.…”

Section: Observational Studies Excluded From Meta-analysismentioning

confidence: 99%

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Maternal thyroid hormone insufficiency during pregnancy and risk of neurodevelopmental disorders in offspring: A systematic review and meta‐analysis

Thompson

Russell

Baragwanath

et al. 2018

Clinical Endocrinology

125

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SummaryBackgroundIn the last 2 decades, several studies have examined the association between maternal thyroid hormone insufficiency during pregnancy and neurodevelopmental disorders in children and shown conflicting results.AimThis systematic review aimed to assess the evidence for an association between maternal thyroid hormone insufficiency during pregnancy and neurodevelopmental disorders in children. We also sought to assess whether levothyroxine treatment for maternal thyroid hormone insufficiency improves child neurodevelopment outcomes.MethodsWe performed systematic literature searches in MEDLINE, EMBASE, PSYCinfo, CINAHL, AMED, BNI, Cochrane, Scopus, Web of Science, GreyLit, Grey Source and Open Grey (latest search: March 2017). We also conducted targeted web searching and performed forwards and backwards citation chasing. Meta‐analyses of eligible studies were carried out using the random‐effects model.ResultsWe identified 39 eligible articles (37 observational studies and 2 randomized controlled trials [RCT]). Meta‐analysis showed that maternal subclinical hypothyroidism and hypothyroxinaemia are associated with indicators of intellectual disability in offspring (odds ratio [OR] 2.14, 95% confidence interval [CI] 1.20 to 3.83, P = .01, and OR 1.63, 95% CI 1.03 to 2.56, P = .04, respectively). Maternal subclinical hypothyroidism and hypothyroxinaemia were not associated with attention deficit hyperactivity disorder, and their effect on the risk of autism in offspring was unclear. Meta‐analysis of RCTs showed no evidence that levothyroxine treatment for maternal hypothyroxinaemia or subclinical hypothyroidism reduces the incidence of low intelligence quotient in offspring.LimitationsAlthough studies were generally of good quality, there was evidence of heterogeneity between the included observational studies (I 2 72%‐79%).ConclusionMaternal hypothyroxinaemia and subclinical hypothyroidism may be associated with intellectual disability in offspring. Currently, there is no evidence that levothyroxine treatment, when initiated 8‐ to 20‐week gestation (mostly between 12 and 17 weeks), for mild maternal thyroid hormone insufficiency during pregnancy reduces intellectual disability in offspring.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Observational Studies Excluded From Meta-analysismentioning

confidence: 99%

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Maternal thyroid hormone insufficiency during pregnancy and risk of neurodevelopmental disorders in offspring: A systematic review and meta‐analysis

Thompson

Russell

Baragwanath

et al. 2018

Clinical Endocrinology

125

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“…Thyroid hormone disorders are contributors to the majority of maternal pregnancy-related complications and adverse pregnancy outcomes (2). Maternal hypothyroidism is strongly associated with preterm birth, low birth weight, reduced head circumference growth in infants and young children, placental abruption, cognitive delay and many other abnormal neurobehavioural problems of exposed offspring (3,4,5,6,7,8). On the other hand, maternal hyperthyroidism is also found to be robustly associated with maternal and foetal adverse events, such as pre-eclampsia, miscarriage, stillbirth, preterm birth and intrauterine growth restriction (4).…”

Section: Introductionmentioning

confidence: 99%

MECHANISMS IN ENDOCRINOLOGY: Maternal thyroid dysfunction during pregnancy and behavioural and psychiatric disorders of children: a systematic review

Fetene

Betts

Alati

2017

European Journal of Endocrinology

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Background: Maternal thyroid dysfunction during pregnancy may lead to persistent neurodevelopmental disorders in the offspring appearing in later life. This study aimed to review the available evidence concerning the relationship between maternal thyroid status during pregnancy and offspring behavioural and psychiatric disorders. Methods: Systematic electronic database searches were conducted using PubMed, Embase, PsycNET, Scopus, Google Scholar and Cochrane library. Studies including gestational thyroid dysfunction as the exposure and offspring behavioural and psychiatric disorders as the outcome were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed and, after thorough screening by two independent reviewers, 13 articles remained eligible for inclusion in this study. Results: Indicators of maternal thyroid dysfunction, including low and high thyroid hormone level and autoimmune thyroiditis, during early pregnancy, were found to be associated with several offspring behavioural and psychiatric disorders such as attention deficit hyperactivity disorder (ADHD), autism, pervasive developmental problems, externalising behaviour, in addition to epilepsy and seizure. The majority of associations were found with low maternal thyroid hormone level. Conclusion: Maternal thyroid function during pregnancy, particularly hypothyroidism, is associated with behavioural and psychiatric disorders in children. Further studies are needed with a capacity to adjust for a fuller range of confounding factors.

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“…This means that the iodine intake, which is already often below the indicated values at baseline, needs to be increased at least to 50% [55]. However, several surveys have demonstrated how frequent iodine deficiency is in pregnant women, both in developed and in developing countries [56-58]. Recent studies investigating the effects of hypothyroxinemia on fetal neurodevelopment, in general terms, have reported a negative correlation, especially when it occurs during the first trimester [30].…”

Section: Maternal Hypothyroidismmentioning

confidence: 99%

Effect of Thyroid Hormones on Neurons and Neurodevelopment

Prezioso¹,

Giannini²,

Chiarelli³

2018

Horm Res Paediatr

131

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Maternal overt hypothyroidism and neurobehavioral outcome of neonates: A cohort study from an iodine-deficient area of Northern India

Abstract: Overt maternal hypothyroidism in iodine-deficient area constitutes a risk factor for an abnormal neurobehavioral development of affected child.

Cited by 6 publications

References 9 publications

Maternal thyroid hormone insufficiency during pregnancy and risk of neurodevelopmental disorders in offspring: A systematic review and meta‐analysis

Maternal thyroid hormone insufficiency during pregnancy and risk of neurodevelopmental disorders in offspring: A systematic review and meta‐analysis

MECHANISMS IN ENDOCRINOLOGY: Maternal thyroid dysfunction during pregnancy and behavioural and psychiatric disorders of children: a systematic review

Effect of Thyroid Hormones on Neurons and Neurodevelopment

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