Neurodevelopment in Children Born to Hypothyroid Mothers Restored to Normal Thyroxine (T<sub>4</sub>) Concentration by Late Pregnancy in Japan: No Apparent Influence of Maternal T<sub>4</sub>Deficiency

Momotani, Naoko; Iwama, Saika; Momotani, Ko

doi:10.1210/jc.2011-2797

Cited by 37 publications

(18 citation statements)

References 31 publications

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“…According to a hospital-based study in Japan, SCH might be induced by an iodine excess during early pregnancy, but there was no association between serum TSH above 4.9 μU/ml during early pregnancy and child developmental testing (Orito et al 2009). It is also reported that children born to women with hypothyroidism at early pregnancy and whose condition was restored to a normal thyroxine concentration by late pregnancy had a normal neurodevelopmental outcome (Momotani et al 2012). We showed that elevated TSH detected until mid pregnancy was not associated with an overall adverse pregnancy event when considering low prevalence of thyroid autoimmunity.…”

Section: Discussionmentioning

confidence: 49%

Women with Subclinical Hypothyroidism Are at Low Risk of Poor Pregnancy Outcome in Japan

Furukawa

Miyakawa

Shibata

et al. 2017

Tohoku J. Exp. Med.

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Maternal subclinical hypothyroidism may be associated with adverse pregnancy outcomes, although not consistently across regions. Here, we sought to determine the effect of elevated thyroid-stimulating hormone (TSH) on pregnancy outcomes in Japanese women without known medical complications. TSH was determined by dried blood spots at 8-20 weeks of gestation, and 3.0-10.0 μ U/mL of TSH was considered as elevated TSH (eTSH). A retrospective study involving 167 cases of eTSH was conducted. Five hundred and seventy eight of controls with normal TSH and without thyroid antibodies were selected. We compared a composite adverse maternal outcome comprised of spontaneous abortion, premature delivery, gestational diabetes mellitus (GDM), placental abruption, and pregnancy-induced hypertension, as well as composite adverse neonatal outcome including stillbirths, heavy for date, light for date, and a low Apgar score (< 7) at 5 minutes between two groups. The incidence of GDM was significantly higher in eTSH (p < 0.01); however, composite adverse maternal and neonatal outcome did not differ between groups (p = 0.19 and p = 0.50, respectively). Although 27 out of 167 cases in eTSH have antibodies, composite adverse outcome did not differ between eTSH with antibodies and controls (p = 0.64 and p = 0.50, respectively). Additionally, composite adverse maternal and neonatal outcome did not differ between the group larger than the median of TSH in eTSH (n = 81) and controls (p = 0.43 and p = 0.98, respectively). Thus, elevated TSH is not associated with overall adverse pregnancy outcomes in women without known medical complications.

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Section: Discussionmentioning

confidence: 49%

Women with Subclinical Hypothyroidism Are at Low Risk of Poor Pregnancy Outcome in Japan

Furukawa

Miyakawa

Shibata

et al. 2017

Tohoku J. Exp. Med.

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“…However, in a recent report (11), women who had severe hypothyroidism in early pregnancy, but who were restored to normal later in pregnancy, had offspring who developed normally. The authors postulate that iodine deficiency may be the factor that leads to abnormal development.…”

Section: Discussionmentioning

confidence: 94%

3,3′-Diiodothyronine sulfate cross-reactive material (compound W) in human newborns

Chen

Yu²,

Bao³

et al. 2012

Pediatr Res

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Background: Thyrosulfoconjugation appears to facilitate fetal-to-maternal transfer of 3,3′-diiodothyronine-sulfate (T 2 s). elevated maternal levels of T 2 s cross-reactive material (compound W) are found in humans, with higher levels found in venous cord blood than in arterial samples. These findings are consistent with the postulate that the placenta plays an essential role in compound W production. Methods: serum compound W levels were measured by a T 2 s-specific radioimmunoassay in 60 serum samples from newborns with hyperbilirubinemia, age 1-30 d. In addition, 59 maternal serum samples, from day 1 to day 7 after uneventful deliveries, were studied. results: as compared with day 1, at day 5, the mean (±se) compound W level fell to 43.5 ± 6.8% (decay half-life (t 1/2 ) = 4.12 d) and to 33.7 ± 4.6% (decay t 1/2 = 2.82 d) in the newborn and maternal groups, respectively. In the mothers, the level continued to decline along the same slope through day 7. In the newborns, however, the mean compound W level entered a slower phase of decay after the fifth day with a decay t 1/2 = 10.9 d. conclusion: compound W is cleared at similar rates in newborn and postpartum maternal sera. This is consistent with the postulate that compound W is produced in the placenta.

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“…On the other hand, a paper reported that maternal T4 deficiency in early pregnancy does not necessarily affect neurodevelopment 19) .…”

Section: Discussionmentioning

confidence: 97%

Diagnostic Significance of Subclinical Hypothyroidism in Health Check-ups

Hashimoto

Ikekubo

Ika

et al. 2013

HEP

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Subclinical hypothyroidism (SHT) is defined as an asymptomatic state associated with normal serum FT4 and a slightly elevated serum TSH concentration. Patients with SHT have a high rate of progression to clinically overt hypothyroidism (OHT), and in addition, SHT is thought to be a risk factor for atherosclerosis and coronary heart disease. The aim of this study was to identify SHT patients and refer them to a thyroid specialist for treatment and management. We retrospectively studied 1168 subjects (324 males and 844 females) who received health check-ups including thyroid function tests in our Health Service Association Clinic over a period of three years and eleven months. Sixty subjects (5.1%) were diagnosed as SHT. The TSH/FT4 ratio (SHT index) was found to be helpful for diagnosing SHT. The main causes of SHT were Hashimoto's thyroiditis, excess dietary iodine intake. L-thyroxine replacement therapy was recommended for patients with a TSH greater than 10 μU/mL. For patients with very mild SHT who are pregnant or anticipate becoming pregnant, L-thyroxine therapy should be started. We devised a flowchart for the diagnosis and management of SHT.

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Neurodevelopment in Children Born to Hypothyroid Mothers Restored to Normal Thyroxine (T₄) Concentration by Late Pregnancy in Japan: No Apparent Influence of Maternal T₄Deficiency

Abstract: In iodine-sufficient areas, maternal T₄ deficiency in early pregnancy does not necessarily affect neurodevelopment. Therefore, other potential factors altering neurodevelopment, such as iodine deficiency, must be investigated.

Cited by 37 publications

References 31 publications

Women with Subclinical Hypothyroidism Are at Low Risk of Poor Pregnancy Outcome in Japan

Women with Subclinical Hypothyroidism Are at Low Risk of Poor Pregnancy Outcome in Japan

3,3′-Diiodothyronine sulfate cross-reactive material (compound W) in human newborns

Diagnostic Significance of Subclinical Hypothyroidism in Health Check-ups

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Neurodevelopment in Children Born to Hypothyroid Mothers Restored to Normal Thyroxine (T4) Concentration by Late Pregnancy in Japan: No Apparent Influence of Maternal T4Deficiency

Abstract: In iodine-sufficient areas, maternal T₄ deficiency in early pregnancy does not necessarily affect neurodevelopment. Therefore, other potential factors altering neurodevelopment, such as iodine deficiency, must be investigated.

Cited by 37 publications

References 31 publications

Women with Subclinical Hypothyroidism Are at Low Risk of Poor Pregnancy Outcome in Japan

Women with Subclinical Hypothyroidism Are at Low Risk of Poor Pregnancy Outcome in Japan

3,3′-Diiodothyronine sulfate cross-reactive material (compound W) in human newborns

Diagnostic Significance of Subclinical Hypothyroidism in Health Check-ups

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Product

Resources

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Neurodevelopment in Children Born to Hypothyroid Mothers Restored to Normal Thyroxine (T₄) Concentration by Late Pregnancy in Japan: No Apparent Influence of Maternal T₄Deficiency