Maternal Thyroid Antibodies Associates With Cardiometabolic Risk Factors in Children at the Age of 16

Anna-Leena Heikkinen; Fanni Päkkilä; Anna-Liisa Hartikainen; Marja Vääräsmäki; Tuija Männistö; Eila Suvanto

Disclosures

J Clin Endocrinol Metab. 2017;102(11):4184-4190. 

In This Article

Abstract and Introduction

Abstract

Context and Objective: The objective of this study was to determine the effects of maternal thyroid dysfunction or antibodies during pregnancy on the cardiometabolic risk factors in children.

Design, Setting, and Participants: This prospective population-based cohort study, Northern Finland Birth Cohort 1986, included all pregnancies within a year in the area. Maternal serum samples were collected before the 20th week of gestation and analyzed for thyrotropin, free T4, thyroidperoxidase antibodies (TPO-Abs), and thyroglobulin antibodies (Tg-Abs). Cardiometabolic risk factors in children at the age of 16 years were evaluated via blood sampling and clinical examination. Data were available for 3229 to 4176 mother–child pairs.

Main Outcome Measures: Waist circumference, blood pressure, lipids and lipoproteins, and insulin resistance were measured. Odds ratios (ORs) with 95% confidence intervals (CIs) of cardiometabolic risk factors in children with and without mothers with thyroid dysfunction or antibodies were calculated with logistic regression and adjusted for covariates.

Results: Children of TPO-Ab–positive mothers had higher odds of metabolic syndrome (OR, 2.57; 95%, CI 1.26 to 5.25) and waist circumference indicative of metabolic syndrome (OR, 1.69; 95% CI, 1.14 to 2.50). They were also more likely to be overweight or obese (OR, 1.56; 95% CI, 1.04 to 2.34). Maternal thyroid dysfunction or Tg-Ab positivity did not associate with cardiometabolic risk factors in children.

Conclusion: Metabolic syndrome, greater waist circumference, and higher body mass index were more prevalent in children of TPO-Ab–positive mothers, indicating an adverse cardiovascular health profile.

Introduction

The intrauterine milieu affects a child's later cardiovascular health.[1] The possible factors leading to these effects can be maternal, such as chronic diseases, or environmental, such as smoking and nutrition. Normal thyroid function is essential in maintaining a normal pregnancy.[2] Maternal thyroid dysfunction is prevalent in up to 5% of pregnancies, and 5% to 15% of all pregnant women are thyroid autoantibody positive.[3,4] Maternal thyroid hormones and antibodies cross the placenta, and thyroid hormones have an important role in fetal development.[5] Therefore, maternal thyroid dysfunction can have serious consequences for the fetus.[2,4–7]

Maternal thyroid dysfunction has been associated with several perinatal complications, poor motor development, and adverse neuropsychological development of the child.[4,8–10] There are very few data on the effects of maternal thyroid dysfunction on the cardiometabolic risk factors of the child. Low maternal thyrotropin (TSH) concentrations have been associated with lower body mass index (BMI), total fat mass, and diastolic blood pressure of the child at the age of 6 years.[11] That same study also showed that high maternal free thyroxine (fT4) concentrations are associated with lower childhood BMI.[11] Studies on older children or adolescents are, to our knowledge, lacking. Among adults, hypothyroidism has been associated with cardiovascular diseases, but studies concerning cardiovascular disease or its risk factors and thyroid-peroxidase antibody (TPO-Ab) positivity are inconsistent.[12–14]

The aim of this study was to investigate the relationship between maternal thyroid dysfunction and antibodies during pregnancy and components of metabolic syndrome in the child at the age of 16 years.

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