Maternal Thyroid Autoantibodies during the Third Trimester and Hearing Deficits in Children: An Epidemiologic Assessment

Abstract

Elevated maternal thyroid autoantibodies during pregnancy are linked to infertility, miscarriage, and neurodevelopmental deficits such as in cognitive function. It has not been established whether autoantibodies to thyroid peroxidase are associated with sensorineural hearing loss (SNHL). The authors tested stored third-trimester maternal serum specimens of 1,736 children for thyroid peroxidase autoantibodies (TPOaAb) by using an enzyme-linked immunosorbent assay technique. The children participated at the Baltimore, Maryland, site of the Collaborative Perinatal Project, which enrolled pregnant women in 1959-1965. An audiology examination was administered to the children at 8 years of age and was used to identify cases of SNHL. Compared with 4.3% of the other children, 22.7% of the children whose mothers had elevated TPOaAb (> or =62.5 IU/ml) had SNHL. The difference was significant after controlling for maternal race, age, and hypothyroidism (exact prevalence odds ratio = 7.5, 95% confidence interval: 2.4, 23.3). When a lower cutoff of TPOaAb > or =31.25 IU/ml was used, there continued to be an association with SNHL (exact prevalence odds ratio = 5.7, 95% confidence interval: 2.1, 15.6). The direction and magnitude of the association were similar when an alternative case definition of SNHL was used. These data suggest that antenatal exposure to maternal TPOaAb during the third trimester of pregnancy is associated with impaired auditory development.

Maternal Thyroxine Levels During Pregnancy and Outcomes of Cognitive Development in Children

“…After screening the titles and abstracts, 22 studies were further assessed for eligibility by reading full-text [12][13][14][15][16][17][18][19]. After reviewing full-text, 15 articles were excluded because of not relevant design or lack of usable data [12,[23][24][25][26][27][28][29][30][31][32][33][34][35][36]. Thus, seven prospective cohort studies were finally included into the metaanalysis [13][14][15][16][17][18][19].…”

Causative Factors in Cerebral Palsy

“…16) in term infants, to CP, 48 to decreased IQ, 51 and to congenital deafness. 52 Antithyroid antibodies are present in 10% of pregnancies 53 and 10% of neonates. 54 No study has sought to examine further the possibility that thyroid hormone level or presence of antithyroid antibodies contributes importantly to encephalopathy in term neonates or to CP, although if present these associations would suggest potential therapeutic interventions.…”

Childhood IQ, hearing loss, and maternal thyroid autoimmunity in the Baltimore Collaborative Perinatal Project

“…We previously observed that TPOaAb elevation in women during the third trimester of pregnancy was strongly (prevalence odds ratio 7.5) and significantly (95% confidence interval: 2.4, 23.3) associated with sensorineural hearing loss (SNHL) in their children (14). The strength of the association became more robust as the TPOaAb concentration increased, even in women who were clinically euthyroid.…”