Association Between Maternal Hypothyroidism and Autism Spectrum Disorders in Children

Overview

Journal Pediatr Res

Specialties Biology
Pediatrics

Date 2017 Dec 16

PMID 29244797

Citations 13

Authors

Darios Getahun

Steven J Jacobsen

Michael J Fassett

Deborah A Wing

Anny H Xiang

Vicki Y Chiu

Morgan R Peltier

Affiliations

Soon will be listed here.

Abstract

BackgroundTo determine whether hypothyroidism is associated with autism spectrum disorders (ASD) and how this association is influenced by race-ethnicity, sex, and timing of exposure.MethodsA retrospective cohort study was conducted using records from 397,201 children who were delivered from 1991 to 2011 and remained health plan members from 1993 to 2014.ResultsChildren of hypothyroid women had higher ASD rates than children of women without the diagnosis (2.14 vs. 1.62/1,000 person-years; adjusted hazard ratios (adj.HR), 1.31; 95% confidence interval (CI), 1.13-1.53). This occurred in women diagnosed before as well as during pregnancy. Maternal hypothyroidism was associated with ASD for both boys (3.93 vs. 2.62/1,000 person-years; adj.HR, 1.27; 95% CI, 1.07-1.50) and girls (1.10 vs. 0.61/1,000 person-years; adj.HR, 1.51; 95% CI, 1.10-2.08). Of women with a diagnosis of hypothyroidism during pregnancy, normal thyroid-stimulating hormone (TSH) and free thyroxine (fT4) levels were not associated with an increased risk of ASD in children. Compared with white children, prenatal hypothyroidism was associated with an increased risk of ASD in children of Hispanics (adj.HR, 1.09; 95% CI, 1.01-1.17) and women of other/mixed race-ethnicity (adj.HR, 1.08; 95% CI, 1.00-1.16).ConclusionMaternal hypothyroidism is associated with ASD in children in a manner dependent on race-ethnicity. Management of maternal hypothyroidism may ameliorate the risk of ASD.

Citing Articles

Maternal plasma phospholipid polyunsaturated fatty acids in early pregnancy and thyroid function throughout pregnancy: a longitudinal study.

Li L, Lu R, Rawal S, Birukov A, Weir N, Tsai M Am J Clin Nutr. 2024; 119(4):1065-1074.

PMID: 38408725 PMC: 11181349. DOI: 10.1016/j.ajcnut.2024.02.016.

The domestic chick as an animal model of autism spectrum disorder: building adaptive social perceptions through prenatally formed predispositions.

Matsushima T, Izumi T, Vallortigara G Front Neurosci. 2024; 18:1279947.

PMID: 38356650 PMC: 10864568. DOI: 10.3389/fnins.2024.1279947.

Maternal Thyroid Dysfunction During Pregnancy as an Etiologic Factor in Autism Spectrum Disorder: Challenges and Opportunities for Research.

Kaplan Z, Pearce E, Lee S, Shin H, Schmidt R Thyroid. 2023; 34(2):144-157.

PMID: 38149625 PMC: 10884547. DOI: 10.1089/thy.2023.0391.

Fetal blockade of nicotinic acetylcholine transmission causes autism-like impairment of biological motion preference in the neonatal chick.

Matsushima T, Miura M, Patzke N, Toji N, Wada K, Ogura Y Cereb Cortex Commun. 2023; 3(4):tgac041.

PMID: 37674673 PMC: 10478028. DOI: 10.1093/texcom/tgac041.

Prenatal Exposure to Per- and Polyfluoroalkyl Substances, Maternal Thyroid Dysfunction, and Child Autism Spectrum Disorder.

Shin H, Oh J, Schmidt R, Pearce E Endocrinol Metab (Seoul). 2022; 37(6):819-829.

PMID: 36415960 PMC: 9816503. DOI: 10.3803/EnM.2022.1598.

References

Braun J, Kalkbrenner A, Just A, Yolton K, Calafat A, Sjodin A . Gestational exposure to endocrine-disrupting chemicals and reciprocal social, repetitive, and stereotypic behaviors in 4- and 5-year-old children: the HOME study. Environ Health Perspect. 2014; 122(5):513-20. PMC: 4014765. DOI: 10.1289/ehp.1307261. View

Soldin O, Lai S, Lamm S, Mosee S . Lack of a relation between human neonatal thyroxine and pediatric neurobehavioral disorders. Thyroid. 2003; 13(2):193-8. PMC: 3641764. DOI: 10.1089/105072503321319503. View

Dworzynski K, Ronald A, Bolton P, Happe F . How different are girls and boys above and below the diagnostic threshold for autism spectrum disorders?. J Am Acad Child Adolesc Psychiatry. 2012; 51(8):788-97. DOI: 10.1016/j.jaac.2012.05.018. View

Raz R, Roberts A, Lyall K, Hart J, Just A, Laden F . Autism spectrum disorder and particulate matter air pollution before, during, and after pregnancy: a nested case-control analysis within the Nurses' Health Study II Cohort. Environ Health Perspect. 2014; 123(3):264-70. PMC: 4348742. DOI: 10.1289/ehp.1408133. View

Sadamatsu M, Kanai H, Xu X, Liu Y, Kato N . Review of animal models for autism: implication of thyroid hormone. Congenit Anom (Kyoto). 2006; 46(1):1-9. DOI: 10.1111/j.1741-4520.2006.00094.x. View

Berbel P, Navarro D, Roman G . An evo-devo approach to thyroid hormones in cerebral and cerebellar cortical development: etiological implications for autism. Front Endocrinol (Lausanne). 2014; 5:146. PMC: 4158880. DOI: 10.3389/fendo.2014.00146. View

. ACOG practice bulletin. Thyroid disease in pregnancy. Number 37, August 2002. American College of Obstetrics and Gynecology. Int J Gynaecol Obstet. 2002; 79(2):171-80. DOI: 10.1016/s0020-7292(02)00327-2. View

Taylor P, Okosieme O, Murphy R, Hales C, Chiusano E, Maina A . Maternal perchlorate levels in women with borderline thyroid function during pregnancy and the cognitive development of their offspring: data from the Controlled Antenatal Thyroid Study. J Clin Endocrinol Metab. 2014; 99(11):4291-8. DOI: 10.1210/jc.2014-1901. View

Hallmayer J, Cleveland S, Torres A, Phillips J, Cohen B, Torigoe T . Genetic heritability and shared environmental factors among twin pairs with autism. Arch Gen Psychiatry. 2011; 68(11):1095-102. PMC: 4440679. DOI: 10.1001/archgenpsychiatry.2011.76. View

10.

de Cock M, Maas Y, van de Bor M . Does perinatal exposure to endocrine disruptors induce autism spectrum and attention deficit hyperactivity disorders? Review. Acta Paediatr. 2012; 101(8):811-8. DOI: 10.1111/j.1651-2227.2012.02693.x. View

11.

Peltier M, Koo H, Getahun D, Menon R . Does exposure to flame retardants increase the risk for preterm birth?. J Reprod Immunol. 2014; 107:20-5. PMC: 4396067. DOI: 10.1016/j.jri.2014.11.002. View

12.

Volk H, Hertz-Picciotto I, Delwiche L, Lurmann F, McConnell R . Residential proximity to freeways and autism in the CHARGE study. Environ Health Perspect. 2010; 119(6):873-7. PMC: 3114825. DOI: 10.1289/ehp.1002835. View

13.

Lord C, Rutter M, Goode S, Heemsbergen J, Jordan H, Mawhood L . Autism diagnostic observation schedule: a standardized observation of communicative and social behavior. J Autism Dev Disord. 1989; 19(2):185-212. DOI: 10.1007/BF02211841. View

14.

Aoki Y, Belin R, Clickner R, Jeffries R, Phillips L, Mahaffey K . Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002). Thyroid. 2008; 17(12):1211-23. DOI: 10.1089/thy.2006.0235. View

15.

Fatemi S, Halt A, Realmuto G, Earle J, Kist D, Thuras P . Purkinje cell size is reduced in cerebellum of patients with autism. Cell Mol Neurobiol. 2002; 22(2):171-5. PMC: 11533743. DOI: 10.1023/a:1019861721160. View

16.

Coleman K, Lutsky M, Yau V, Qian Y, Pomichowski M, Crawford P . Validation of Autism Spectrum Disorder Diagnoses in Large Healthcare Systems with Electronic Medical Records. J Autism Dev Disord. 2015; 45(7):1989-96. PMC: 4474741. DOI: 10.1007/s10803-015-2358-0. View

17.

Robinson E, Lichtenstein P, Anckarsater H, Happe F, Ronald A . Examining and interpreting the female protective effect against autistic behavior. Proc Natl Acad Sci U S A. 2013; 110(13):5258-62. PMC: 3612665. DOI: 10.1073/pnas.1211070110. View

18.

. Prevalence of autism spectrum disorder among children aged 8 years - autism and developmental disabilities monitoring network, 11 sites, United States, 2010. MMWR Surveill Summ. 2014; 63(2):1-21. View

19.

Andersen S, Laurberg P, Wu C, Olsen J . Attention deficit hyperactivity disorder and autism spectrum disorder in children born to mothers with thyroid dysfunction: a Danish nationwide cohort study. BJOG. 2014; 121(11):1365-74. DOI: 10.1111/1471-0528.12681. View

20.

Yau V, Lutsky M, Yoshida C, Lasley B, Kharrazi M, Windham G . Prenatal and neonatal thyroid stimulating hormone levels and autism spectrum disorders. J Autism Dev Disord. 2014; 45(3):719-30. PMC: 6472909. DOI: 10.1007/s10803-014-2227-2. View