Maternal Thyroid Dysfunction During Pregnancy and the Risk of Adverse Outcomes in the Offspring: A Systematic Review and Meta-Analysis

J Clin Endocrinol Metab. 2020 Dec 1;105(12):dgaa555. doi: 10.1210/clinem/dgaa555.

Abstract

Context: Previous studies suggested a potential link of maternal thyroid dysfunction with adverse neurocognitive outcomes and impaired development of internal organs in offspring.

Objective: To review the association between maternal thyroid dysfunction and the risk of adverse outcomes in offspring.

Data sources: PubMed, EMBASE, and Cochrane Library.

Study selections: Eligible studies reported the association between maternal thyroid hormone function and the risk of adverse outcomes in their children.

Data extraction: Reviewers extracted data on study characteristics and results independently.

Data synthesis: Estimates were pooled and reported as odds ratio (OR) with 95% confidence interval (CI). I2 tests were applied to assess the heterogeneity across studies.

Results: We identified 29 eligible articles and found an association between maternal hyperthyroidism and attention deficit hyperactivity disorder (ADHD) (OR: 1.18, 95% CI: 1.04-1.34, I2 = 0%) and epilepsy (OR: 1.19, 95% CI: 1.08-1.31, I2 = 0%) in offspring; as well as an association of maternal hypothyroidism with increased risk of ADHD (OR: 1.14, 95% CI: 1.03-1.26, I2 = 25%), autism spectrum disorder (OR: 1.41, 95% CI: 1.05-1.90, I2 = 63%), and epilepsy (OR: 1.21, 95% CI: 1.06-1.39, I2 = 0%) in offspring.

Conclusion: Routine measurement and timely treatment on thyroid function should be considered for pregnant women.

Keywords: child development; gestation; neurodevelopmental disorders; offspring; pregnancy; thyroid.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit Disorder with Hyperactivity / etiology
  • Autism Spectrum Disorder / epidemiology
  • Autism Spectrum Disorder / etiology
  • Epilepsy / epidemiology
  • Epilepsy / etiology
  • Female
  • Humans
  • Hyperthyroidism / complications
  • Hyperthyroidism / epidemiology*
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Pregnancy Outcome / epidemiology*
  • Risk Factors
  • Schizophrenia / epidemiology
  • Schizophrenia / etiology