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Maternal Thyroid Hormone Parameters during Early Pregnancy and Birth Weight: The Generation R Study.
MedLine Citation:
PMID:  23150694     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Context:Maternal hyperthyroidism during pregnancy is associated with an increased risk of low birth weight, predisposing to neonatal morbidity and mortality. However, the effects of variation in maternal serum thyroid parameters within the normal range on birth weight are largely unknown.Objective:The aim was to study the effects of early pregnancy maternal serum thyroid parameters within the normal range on birth weight, as well as the relation between umbilical cord thyroid parameters and birth weight.Design, Setting, and Participants:In early pregnancy, serum TSH, FT4 (free T(4)), and thyroid peroxidase antibody levels were determined in 4464 pregnant women. Cord serum TSH and FT4 levels were determined in 2724 newborns. Small size for gestational age at birth (SGA) was defined as a gestational age-adjusted birth weight below the 2.5th percentile. The associations between normal-range maternal and cord thyroid parameters, birth weight, and SGA were studied using regression analyses.Results:In mothers with normal-range FT4 and TSH levels, higher maternal FT4 levels were associated with lower birth weight [β = -15.4 (3.6) g/pmol · liter, mean (se); P = 1.6 × 10(-5)], as well as with an increased risk of SGA newborns [odds ratio (95% confidence interval) = 1.09 (1.01-1.17); P = 0.03]. Birth weight was positively associated with both cord TSH [β = 4.1 (1.4) g/mU · liter; P = 0.007] and FT4 levels [β = 23.0 (3.2) g/pmol · liter; P = 9.2 × 10(-13)].Conclusions:We show that maternal high-normal FT4 levels in early pregnancy are associated with lower birth weight and an increased risk of SGA newborns. Additionally, birth weight is positively associated with cord TSH and FT4 levels. These data demonstrate that even mild variation in thyroid function within the normal range can have important fetal consequences.
Authors:
Marco Medici; Sarah Timmermans; Willy Visser; Sabine M P F de Muinck Keizer-Schrama; Vincent W W Jaddoe; Albert Hofman; Herbert Hooijkaas; Yolanda B de Rijke; Henning Tiemeier; Jacoba J Bongers-Schokking; Theo J Visser; Robin P Peeters; Eric A P Steegers
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-12
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  -     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
The Generation R Study Group (M.M., S.T., V.W.W.J.) and Departments of Internal Medicine (M.M., Y.B.d.R., T.J.V., R.P.P.), Epidemiology (V.W.W.J., A.H., H.T.), and Immunology (H.H.); Erasmus Medical Center, 3015 GE Rotterdam, The Netherlands; and Departments of Obstetrics and Gynecology (S.T., W.V., E.A.P.S.), Pediatrics (S.M.P.F.d.M.K.-S., V.W.W.J.), Clinical Chemistry (Y.B.d.R.), Child and Adolescent Psychiatry (H.T.), and Endocrinology (J.J.B.-S.), Erasmus Medical Center-Sophia Children's Hospital, 3000 CB Rotterdam, The Netherlands.
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