Newborn TSH concentration and its association with cognitive development in healthy boys

Abstract

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.

Transient neonatal hyperthyrotropinemia is a risk factor for developing persistent hyperthyrotropinemia in childhood with repercussion on developmental status

“…For these reasons, we usually treat infants with PH with levothyroxine (L-T 4 ), at any age, as long as TSH levels remain above 10 mU/l in at least two determinations, separated by intervals of not !3 months, even with a normal ultrasound, normal ioduria, and absence of antithyroid antibodies. We are aware that this issue is controversial, but in the light of other authors' results and our own results, this approach seems to be accurate to us (23).…”

Thyroid status and its association with cognitive functioning in healthy boys at 10 years of age

“…For instance, a cross-sectional study nested in the same cohort showed lower general cognitive and quantitative capacities and executive function in 4-year-old boys with higher neonatal TSH levels (4.19-17.0 mIU/ml) (8). In addition, 4-year-old boys and girls in the INMA cohort with neonatal TSH concentrations in the range of 2.43-5.01 mIU/ml evidenced impaired memory and verbal skills and higher attention deficit and hyperactivity/ impulsivity symptoms in comparison with those with lower TSH concentrations (4).…”

“…Clinical Study R Pé rez-Lobato and others Thyroid status and cognitive functioning with overt thyroid diseases or in high-risk environments, including children with congenital hypothyroidism (6), neurological disorders, or thyroid hormone resistance syndrome or those living in iodine-deficient areas (2,4,8). Numerous environmental agents can produce marginal reductions of circulating THs.…”

“…Few studies have addressed the association between mild-to-moderate alterations of thyroid function in children and their subsequent neuropsychological functioning (6,10), and there are almost no studies investigating the neurodevelopment of healthy children with TH or thyrotropin (TSH) levels that only slightly differ from the 'normal' range, except for two studies from the Spanish Environment and Childhood 'Infancia y Medio Ambiente (Childhood and Environment) (INMA)' mother-child cohort study (4,8).…”

Disfunções cognitivas em pacientes com hipotireoidismo subclínico

“…Dessa forma, deve-se pensar na possibilidade de existirem outros marcadores laboratoriais mais específicos que, de forma direta ou indireta, estariam associados aos níveis de TSH. Essa relação, entre níveis de TSH e disfunção cognitiva, foi recentemente avaliada em uma coorte com 178 recém-nascidos, em que níveis de TSH no cordão umbilical apresentaram uma correlação positiva com disfunções executivas futuras (15). Alternativamente, níveis de TSH podem exercer feed-back negativo em vias neuroendócrinas associadas ao desempenho cognitivo, ainda não totalmente elucidadas (1)(2)(3)5,11,16).…”