This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Männistö, T. Articles by Suvanto-Luukkonen, E. Search for Related Content PubMed PubMed Citation Articles by Männistö, T. Articles by Suvanto-Luukkonen, E. Related Collections Pediatric Endocrinology Thyroid Autoimmunity

Perinatal Outcome of Children Born to Mothers with Thyroid Dysfunction or Antibodies: A Prospective Population-Based Cohort Study

Departments of Obstetrics and Gynecology (T.M., M.V., A.P., A.-L.H., E.S.-L.) and Clinical Chemistry (A.R.), and Institute of Health Sciences (T.M., M.-R.J.), University of Oulu, 90014 Oulu, Finland; Department of Child and Adolescent Health (A.P., H.-M.S., A.B., M.-R.J.), National Public Health Institute, 90101 Oulu, Finland; and Department of Epidemiology and Public Health (M.-R.J.), Imperial College London, London SW7 2AZ, United Kingdom

Address all correspondence and requests for reprints to: Eila Suvanto-Luukkonen, Department of Obstetrics and Gynecology, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland. E-mail: eila.suvantoluukkonen{at}ppshp.fi.

Context: There are only a few large prospective studies involving evaluation of the effect of maternal thyroid dysfunction on offspring and observations are inconsistent.

Objective: The objective of the study was to investigate the effects of thyroid dysfunction or antibody positivity on perinatal outcome.

Setting and Participants: The study included prospective population-based Northern Finland Birth Cohort 1986 including 9247 singleton pregnancies. First-trimester maternal serum samples were analyzed for thyroid hormones [TSH, free T₄ (fT4)] and antibodies [thyroid-peroxidase antibody (TPO-Ab) and thyroglobulin antibody (TG-Ab)]. Mothers were classified by their hormone and antibody status into percentile categories based on laboratory data and compared accordingly.

Main Outcomes: Outcomes were perinatal mortality, preterm delivery, absolute and gestational age-adjusted birth weight, and absolute and relative placental weight.

Results: The offspring of TPO-Ab- and TG-Ab-positive mothers had higher perinatal mortality, which was not affected by thyroid hormone status. Unadjusted and adjusted (for maternal age and parity) risk for increased perinatal mortality was an odds ratio of 3.1 (95% confidence interval 1.4–7.1) and 3.2 (1.4–7.1) in TPO-Ab- and 2.6 (1.1–6.2) and 2.5 (1.1–5.9) in TG-Ab-positive mothers. TPO-Ab-positive mothers had more large-for-gestational age infants (2.4 vs. 0.8%, P = 0.017), as did mothers with low TSH and high fT4 concentrations vs. reference group (6.6 vs. 2.5%, P = 0.045). Significantly higher placental weights were observed among mothers with low TSH and high fT4 or high TSH and low fT4 levels as well as among TPO-Ab-positive mothers.

Conclusions: First-trimester antibody positivity is a risk factor for perinatal death but not thyroid hormone status as such. Thyroid dysfunction early in pregnancy seems to affect fetal and placental growth.

This article has been cited by other articles:

				S. K. Varma Maternal Thyroid Autoantibodies Predict Poor Perinatal Outcomes AAP Grand Rounds, July 1, 2009; 22(1): 5 - 5. [Full Text] [PDF]