Maternal thyroid hormone insufficiency during pregnancy and risk of neurodevelopmental disorders in offspring: A systematic review and meta-analysis
dc.contributor.author | Thompson, W | |
dc.contributor.author | Russell, G | |
dc.contributor.author | Baragwanath, G | |
dc.contributor.author | Matthews, J | |
dc.contributor.author | Vaidya, B | |
dc.contributor.author | Thompson-Coon, J | |
dc.date.accessioned | 2020-06-09T10:46:44Z | |
dc.date.issued | 2018-01-11 | |
dc.description.abstract | Background: In the last 2 decades, several studies have examined the association between maternal thyroid hormone insufficiency during pregnancy and neurodevelopmental disorders in children and shown conflicting results. Aim: This systematic review aimed to assess the evidence for an association between maternal thyroid hormone insufficiency during pregnancy and neurodevelopmental disorders in children. We also sought to assess whether levothyroxine treatment for maternal thyroid hormone insufficiency improves child neurodevelopment outcomes. Methods: We performed systematic literature searches in MEDLINE, EMBASE, PSYCinfo, CINAHL, AMED, BNI, Cochrane, Scopus, Web of Science, GreyLit, Grey Source and Open Grey (latest search: March 2017). We also conducted targeted web searching and performed forwards and backwards citation chasing. Meta-analyses of eligible studies were carried out using the random-effects model. Results: We identified 39 eligible articles (37 observational studies and 2 randomized controlled trials [RCT]). Meta-analysis showed that maternal subclinical hypothyroidism and hypothyroxinaemia are associated with indicators of intellectual disability in offspring (odds ratio [OR] 2.14, 95% confidence interval [CI] 1.20 to 3.83, P =.01, and OR 1.63, 95% CI 1.03 to 2.56, P =.04, respectively). Maternal subclinical hypothyroidism and hypothyroxinaemia were not associated with attention deficit hyperactivity disorder, and their effect on the risk of autism in offspring was unclear. Meta-analysis of RCTs showed no evidence that levothyroxine treatment for maternal hypothyroxinaemia or subclinical hypothyroidism reduces the incidence of low intelligence quotient in offspring. Limitations: Although studies were generally of good quality, there was evidence of heterogeneity between the included observational studies (I2 72%-79%). Conclusion: Maternal hypothyroxinaemia and subclinical hypothyroidism may be associated with intellectual disability in offspring. Currently, there is no evidence that levothyroxine treatment, when initiated 8- to 20-week gestation (mostly between 12 and 17 weeks), for mild maternal thyroid hormone insufficiency during pregnancy reduces intellectual disability in offspring. | en_GB |
dc.description.sponsorship | Wellcome Trust | en_GB |
dc.description.sponsorship | National Institute for Health Research (NIHR) | en_GB |
dc.identifier.citation | Vol. 88 (4), pp. 575 - 584 | en_GB |
dc.identifier.doi | 10.1111/cen.13550 | |
dc.identifier.grantnumber | 108676/Z/1 | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/121336 | |
dc.language.iso | en | en_GB |
dc.publisher | Wiley for Society for Endocrinology | en_GB |
dc.rights | © 2018 The Authors. Clinical Endocrinology Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. | en_GB |
dc.subject | autism | en_GB |
dc.subject | hypothyroxinaemia | en_GB |
dc.subject | intelligent quotient | en_GB |
dc.subject | pregnancy | en_GB |
dc.subject | subclinical hypothyroidism | en_GB |
dc.subject | thyroid | en_GB |
dc.title | Maternal thyroid hormone insufficiency during pregnancy and risk of neurodevelopmental disorders in offspring: A systematic review and meta-analysis | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2020-06-09T10:46:44Z | |
dc.identifier.issn | 0300-0664 | |
dc.description | This is the final version. Available on open access from Wiley via the DOI in this record | en_GB |
dc.identifier.journal | Clinical Endocrinology | en_GB |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | en_GB |
dcterms.dateAccepted | 2018-01-07 | |
exeter.funder | ::Wellcome Trust | en_GB |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2018-01-11 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2020-06-09T10:44:18Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2020-06-09T10:46:47Z | |
refterms.panel | A | en_GB |
refterms.depositException | publishedGoldOA |
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Except where otherwise noted, this item's licence is described as © 2018 The Authors. Clinical Endocrinology Published by John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.