Association between maternal thyroid dysfunction and neurodevelopmental disorders in offspring: a population-based cohort study.

This large study looked at over 3 million children to see if mothers' thyroid problems during pregnancy affect their children's development. Children whose mothers had thyroid problems (either overactive or underactive thyroid) were more likely to be diagnosed with ADHD or autism. However, when mothers with overactive thyroid took a specific medication called PTU throughout pregnancy, their children had lower risks of ADHD and autism.

This large population-based cohort study of 3.17 million children examined associations between maternal thyroid dysfunction during pregnancy and neurodevelopmental disorders in offspring. Both maternal hyperthyroidism and hypothyroidism were associated with increased risks of ADHD and autism spectrum disorder in children. Specifically, maternal hyperthyroidism increased ADHD risk by 19% and ASD risk by 14%, while maternal hypothyroidism increased ADHD risk by 28% and ASD risk by 34%. Interestingly, continuous use of propylthiouracil (PTU) for treating maternal hyperthyroidism was associated with reduced risks of both ADHD and ASD in offspring, suggesting potential protective effects of appropriate thyroid medication management during pregnancy.

Results suggest importance of thyroid function screening and management during pregnancy. Healthcare providers should monitor pregnant women for thyroid dysfunction and ensure appropriate treatment. For women with hyperthyroidism, PTU may be preferred over other treatments. These findings support integrated care between obstetric and endocrine services.

Study limitations not explicitly detailed in the abstract. As an observational cohort study, causation cannot be established. Potential confounding factors and medication adherence patterns are not discussed. Long-term follow-up duration and diagnostic criteria for neurodevelopmental disorders are not specified.

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are both common neurodevelopmental disorders (NDDs), but their association between maternal thyroid dysfunction and NDDs in offspring remains equivocal. This study aimed to evaluate the association between maternal thyroid dysfunction, related medications, and neurodevelopmental disorders in offspring. This population-based retrospective birth cohort study included children born between 2004 and 2020, with surveillance continuing through 2021. Maternal thyroid dysfunction during pregnancy was identified by any outpatient or inpatient diagnosis of hyperthyroidism or hypothyroidism.

Medications for hyperthyroidism during pregnancy, including propylthiouracil (PTU) and methimazole (MMI), as well as levothyroxine for hypothyroidism, were also examined. Associations between maternal thyroid dysfunction with medication use and child NDDs were modeled using Cox proportional hazards regression. The study cohort consisted of 3,175,328 live-born children. Among them, 39,294 (1.2%) were born to mothers with hyperthyroidism, and 14,630 (0.5%) had mothers with hypothyroidism.

A higher risk of ADHD was noted in children whose mothers had thyroid dysfunction, whether they had hyperthyroidism (adjusted HR, 1.19; 95% CI,1.14-1.24) or hypothyroidism (adjusted HR,1.28; 95% CI,1.19-1.37), and a similarly increased risk of ASD was observed in association with maternal hyperthyroidism (adjusted HR, 1.14; 95% CI, 1.03-1.27) or hypothyroidism (adjusted HR, 1.34; 95% CI, 1.19-1.51). For medications in treating hyperthyroidism during pregnancy, continuous propylthiouracil (PTU) use was associated with a lower risk of ADHD (adjusted HR, 0.91; 95% CI, 0.83-0.99) or ASD (adjusted HR, 0.80; 95% CI, 0.67-0.96). This study identified the association between maternal thyroid dysfunction during pregnancy and offspring ADHD. Moreover, we observed that continuous use of PTU for treating maternal hyperthyroidism during pregnancy may be associated with a reduced risk of childhood ADHD.