Thyroid Function in Small For Gestational Age Newborns: A Review

Bagnoli, Fábio; Farmeschi, Laura; Nappini, Sara; Grosso, Salvatore

doi:10.4274/jcrpe.846

Cited by 18 publications

(7 citation statements)

References 47 publications

(61 reference statements)

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“…Thyroid hormone is a hormone that has been implicated in mammalian cardiac myocyte terminal differentiation (17, 19 -21) that may play a role in different terminal differentiation in early T fetuses. Low thyroid hormone levels are associated with fetal growth restriction, and there are low circulating total and free thyroid hormones in growth-restricted fetuses (30,45), although there was an insufficient sample to measure thyroid hormone levels in this study. However, free thyroxine and triiodothyronine are not different in cord blood between male and female fetuses (31,48).…”

Section: Discussionmentioning

confidence: 88%

Cardiac myocyte proliferation and maturation near term is inhibited by early gestation maternal testosterone exposure

Jonker

Louey

Roselli

2018

American Journal of Physiology-Heart and Circulatory Physiology

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Polycystic ovary syndrome (PCOS) is a complex and common disorder in women, and those affected experience an increased burden of cardiovascular disease. It is an intergenerational syndrome, as affected women with high androgen levels during pregnancy "program" fetal development, leading to a similar phenotype in their female offspring. The effect of excess maternal testosterone exposure on fetal cardiomyocyte growth and maturation is unknown. METHODS Pregnant ewes received biweekly injections of vehicle (Control) or 100 mg testosterone propionate between 30-59 days of gestation (dGA; Early T) or 60-90 dGA (Late T). Fetuses were delivered at ~135 dGA and their hearts enzymatically dissociated to measure cardiomyocyte growth (dimensional measurements), maturation (proportion binucleate), and proliferation (nuclear Ki-67 protein). RESULTS Early T depressed serum insulin-like growth factor 1 (IGF-1) and caused intrauterine growth restriction (IUGR)(P<0.0005). Hearts were smaller in Early T (P<0.001) due to reduced cardiac myocyte maturation (P<0.0005) and proliferation (P=0.017). Maturation was also less in males than in females (P=0.004), independent of treatment. Late T did not affect cardiac growth. CONCLUSIONS Early excess maternal testosterone exposure depresses circulating IGF-1 near term and causes IUGR in both female and male offspring. These fetuses have small, immature hearts with reduced proliferation, which may reduce cardiac myocyte endowment and predispose to adverse cardiac growth in postnatal life. While excess maternal testosterone exposure leads to PCOS and cardiovascular disease in female offspring, it may also predispose to complications of IUGR and cardiovascular disease in male offspring.

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Section: Discussionmentioning

confidence: 88%

Cardiac myocyte proliferation and maturation near term is inhibited by early gestation maternal testosterone exposure

Jonker

Louey

Roselli

2018

American Journal of Physiology-Heart and Circulatory Physiology

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“… 2 Although the 2 terms are different, SGA is widely considered to be a proxy for IUGR, and weights below 2 SD would capture the majority of fetuses with IUGR. 3 …”

Section: Introductionmentioning

confidence: 99%

The Effect of Subclinical Maternal Thyroid Dysfunction and Autoimmunity on Intrauterine Growth Restriction

Zhao

Zhang

Chen³

et al. 2016

Medicine

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The objective of this study was to evaluate the association between maternal subclinical thyroid dysfunction and autoimmunity with the risk for intrauterine growth restriction (IUGR).Design is a systematic review and meta-analysis.A literature search was conducted using PubMed, Embase, and Cochrane database. A combination of 2 key words was used to search for the eligible studies: one indexed thyroid dysfunction or antithyroid antibodies; and the other one indexed the adverse neonatal outcomes of pregnancy, such as IUGR, small for gestational age, fetal growth restriction, or low birth weight.Two reviewers selected the studies, and eligible studies met the following criteria: prospective cohort studies or case control studies, studies of maternal thyroid dysfunction and positive antithyroid antibodies as the exposure of interest, and studies of IUGR or small for gestational age as the outcome of interest.Data were recorded, including data from maternal thyroid disorders and IUGR, and compared with a reference group.There were 22 individual data from the 13 cohort articles. Among these, 7 were focused on subclinical hypothyroidism (SCH), 4 on subclinical hyperthyroidism, 7 on positivity for thyroid peroxidase antibody (TPOAb), and 4 on isolated hypothyroxinemia. Meta-analysis showed that there was no effect of subclinical hyperthyroidism (odds ratio (OR) = 0.98; 95% confidence interval (CI), 0.40–2.41), TPOAb positivity (OR = 1.57; 95% CI, 0.77–3.18), or isolated hypothyroxinemia (OR = 1.05, 95% CI: 0.37–2.92) on IUGR. However, SCH is associated with IUGR (OR = 1.54; 95% CI, 1.06–2.25).SCH is associated with IUGR; however, subclinical hyperthyroidism, TPOAb positivity, or isolated hypothyroxinemia do not affect the risk of IUGR.

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“…However, while some studies have demonstrated that babies born to women with inadequate dietary iodine intake in the third trimester had lower birth weights than those born to women with adequate intake [36,37], most of them showed no evidence of an association between UIC and birth weight [38][39][40]. This mismatch is based on a great heterogeneity among studies due to a different degree of iodine deficiency (severe vs. moderate-to-mild deficiency); different timing (first trimester, half-gestation, at birth), and different methodology in the evaluation [12,14].…”

Section: Discussionmentioning

confidence: 99%

“…The term intrauterine growth restriction (IUGR) is used to describe a fetus that cannot reach its growth potential due to placental insufficiency, and is associated with poor perinatal outcomes [11]. Although the two terms are different, SGA remains the best clinical surrogate for IUGR, since it would capture the majority of fetuses with this condition [12].…”

Section: Introductionmentioning

confidence: 99%

Iodine Status, Thyroid Function, and Birthweight: A Complex Relationship in High-Risk Pregnancies

Velasco

Sánchez-Gila

Galán

et al. 2020

JCM

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(1) Background: The consequences of iodine deficiency and/or thyroid dysfunction during pregnancy have been extensively studied, emphasizing on infant neurodevelopment. However, the available information about the relationship between iodine, thyroid hormones, and fetal growth in high-risk pregnancies is limited. We aim to investigate if iodine metabolism and/or thyroid parameters can be affected by adverse antenatal/perinatal conditions. (2) Methods: A cross-sectional study examined differences in iodine status, thyroid function, and birthweight between high-risk (HR group; n = 108)) and low-risk pregnancies (LR group; n = 233) at the time of birth. Urinary iodine concentration (UIC), iodine levels in amniotic fluid, and thyroid parameters [thyroid-stimulating hormone (TSH), free thyroxine (FT4)] were measured in mother–baby pairs. (3) Results: There were significant differences between HR and LR groups, free thyroxine (FT4) concentration in cord blood was significantly higher in the LR group compared with HR pregnancies (17.06 pmol/L vs. 15.30 pmol/L, respectively; p < 0.001), meanwhile iodine concentration in amniotic fluid was significantly lower (13.11 µg/L vs. 19.65 µg/L, respectively; p < 0.001). (4) Conclusions: Our findings support the hypothesis that an adverse intrauterine environment can compromise the availability of FT4 in cord blood as well as the iodine metabolism in the fetus. These differences are more noticeable in preterm and/or small fetuses.

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Thyroid Function in Small For Gestational Age Newborns: A Review

Cited by 18 publications

References 47 publications

Cardiac myocyte proliferation and maturation near term is inhibited by early gestation maternal testosterone exposure

Cardiac myocyte proliferation and maturation near term is inhibited by early gestation maternal testosterone exposure

The Effect of Subclinical Maternal Thyroid Dysfunction and Autoimmunity on Intrauterine Growth Restriction

Iodine Status, Thyroid Function, and Birthweight: A Complex Relationship in High-Risk Pregnancies

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