1
|
Hashemi Dehkordi V, Khoshhali M, Heidari-Beni M, Hashemi Dehkordi E, Hashemipour M, Mostofizadeh N, Daniali SS, Kelishadi R. Association Between Dietary Phytochemical Index and Neonatal Thyroid Function. J Pregnancy 2024; 2024:9558023. [PMID: 38919582 PMCID: PMC11199066 DOI: 10.1155/2024/9558023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 09/11/2023] [Accepted: 04/25/2024] [Indexed: 06/27/2024] Open
Abstract
Background: Thyroid hormones regulate fetal growth and differentiation of several tissues. Maternal dietary patterns may be correlated with changes in the level of neonatal thyroid-stimulating hormone (TSH). We hypothesized that since maternal nutrition affects birth weight and offspring growth, it may also impact endocrine patterns in offspring. This study is aimed at assessing the relationship between maternal dietary phytochemical index (DPI) in the first trimester of pregnancy and neonatal cord blood thyroid hormone levels. Methods: This cross-sectional study is a substudy of a birth cohort. Overall, 216 mothers, aged 16-45 years, were recruited in their first trimester of pregnancy. To calculate DPI, the daily energy percentage of phytochemical-rich foods was divided by the total daily energy intake. At delivery time, TSH and free thyroxine (FT4) levels were measured in cord blood samples using chemiluminescence immunoassay. Results: The mean (standard deviation (SD)) age of mothers was 29.56 (5.50) years, and 47% of newborns were girls. The mean (SD) of DPI in the first, second, third, and fourth quartiles was 25.03 ± 4.67, 33.87 ± 2.18, 40.64 ± 2.10, and 51.17 ± 4.98, respectively. There was not any significant correlation between DPI score with cord serum TSH and FT4 levels in crude and adjusted analysis. Conclusion: No significant relationship between maternal DPI with cord serum TSH and FT4 levels was shown. Limited experience exists about the effect of maternal diet quality indices on neonatal thyroid function, and further studies are needed in this regard.
Collapse
Affiliation(s)
- Vida Hashemi Dehkordi
- Department of Pediatric EndocrinologyEndocrine and Metabolism Research CenterIsfahan University of Medical Sciences, Isfahan, Iran
| | - Mehri Khoshhali
- Department of PediatricsChild Growth and Development Research CenterResearch Institute for Primordial Prevention of Non-Communicable DiseaseIsfahan University of Medical Sciences, Isfahan, Iran
| | - Motahar Heidari-Beni
- Department of NutritionChild Growth and Development Research CenterResearch Institute for Primordial Prevention of Non-Communicable DiseaseIsfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Hashemi Dehkordi
- Department of Pediatric EndocrinologyChild Growth and Development Research CentreResearch Institute for Primordial Prevention of Non-Communicable DiseaseIsfahan University of Medical Sciences, Isfahan, Iran
| | - Mahin Hashemipour
- Department of Pediatric EndocrinologyChild Growth and Development Research CentreResearch Institute for Primordial Prevention of Non-Communicable DiseaseIsfahan University of Medical Sciences, Isfahan, Iran
- Metabolic Liver Diseases Research CenterImam Hossein Children's HospitalIsfahan University of Medical Sciences, Isfahan, Iran
| | - Neda Mostofizadeh
- Department of Pediatric EndocrinologyEndocrine and Metabolism Research CenterIsfahan University of Medical Sciences, Isfahan, Iran
| | - Seyede Shahrbanoo Daniali
- Department of PediatricsChild Growth and Development Research CenterResearch Institute for Primordial Prevention of Non-Communicable DiseaseIsfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Department of PediatricsChild Growth and Development Research CenterResearch Institute for Primordial Prevention of Non-Communicable DiseaseIsfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
2
|
Yang M, Cao Z, Zhu W, Feng X, Zhou J, Liu J, Zhong Y, Zhou Y, Mei H, Cai X, Hu L, Zhou A, Xiao H. Associations between OGTT results during pregnancy and offspring TSH levels: a birth cohort study. BMC Pregnancy Childbirth 2024; 24:375. [PMID: 38760653 PMCID: PMC11100047 DOI: 10.1186/s12884-024-06554-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/29/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Limited evidence exists regarding the association between gestational diabetes mellitus (GDM) and elevated levels of thyroid-stimulating hormone (TSH) in newborns. Therefore, this study aimed to investigate the potential risk of elevated TSH levels in infants exposed to maternal GDM, considering the type and number of abnormal values obtained from the 75-gram oral glucose tolerance test (OGTT). METHODS A population-based, prospective birth cohort study was conducted in Wuhan, China. The study included women who underwent GDM screening using a 75-g OGTT. Neonatal TSH levels were measured via a time-resolved immunofluorescence assay. We estimated and stratified the overall risk (adjusted Risk Ratio [RR]) of elevated TSH levels (defined as TSH > 10 mIU/L or > 20 mIU/L) in offspring based on the type and number of abnormal OGTT values. RESULTS Out of 15,236 eligible mother-offspring pairs, 11.5% (1,753) of mothers were diagnosed with GDM. Offspring born to women diagnosed with GDM demonstrated a statistically significant elevation in TSH levels when compared to offspring of non-GDM mothers, with a mean difference of 0.20 [95% CI: 0.04-0.36]. The incidence of elevated TSH levels (TSH > 10 mIU/L) in offspring of non-GDM women was 6.3 per 1,000 live births. Newborns exposed to mothers with three abnormal OGTT values displayed an almost five-fold increased risk of elevated TSH levels (adjusted RR 4.77 [95% CI 1.64-13.96]). Maternal fasting blood glucose was independently and positively correlated with neonatal TSH levels and elevated TSH status (TSH > 20 mIU/L). CONCLUSIONS For newborns of women with GDM, personalized risk assessment for elevated TSH levels can be predicated on the type and number of abnormal OGTT values. Furthermore, fasting blood glucose emerges as a critical predictive marker for elevated neonatal TSH status.
Collapse
Affiliation(s)
- Meng Yang
- Institute of Maternal and Child Health, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Health care Hospital, Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Zhongqiang Cao
- Institute of Maternal and Child Health, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Health care Hospital, Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Wanting Zhu
- Department of Obstetrics, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Health care Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyuan Feng
- Department of echocardiography, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Health care Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Jieqiong Zhou
- Department of Obstetrics, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Health care Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Jiuying Liu
- Department of Obstetrics, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Health care Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Yuanyuan Zhong
- Department of Obstetrics, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Health care Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Zhou
- Department of Obstetrics, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Health care Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Mei
- Institute of Maternal and Child Health, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Health care Hospital, Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Xiaonan Cai
- Institute of Maternal and Child Health, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Health care Hospital, Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Liqin Hu
- Institute of Maternal and Child Health, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Health care Hospital, Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Aifen Zhou
- Institute of Maternal and Child Health, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Health care Hospital, Huazhong University of Science and Technology, Wuhan, 430000, China.
| | - Han Xiao
- Institute of Maternal and Child Health, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Health care Hospital, Huazhong University of Science and Technology, Wuhan, 430000, China.
| |
Collapse
|
3
|
Stryhn JKG, Larsen J, Pedersen PL, Gæde PH. Subclinical hypothyroidism in pregnancy - assessment of offspring thyroid status and mitochondrial robustness to stress. Scand J Clin Lab Invest 2023; 83:501-508. [PMID: 37942740 DOI: 10.1080/00365513.2023.2253726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/28/2023] [Indexed: 11/10/2023]
Abstract
Subclinical hypothyroidism's clinical implications on pregnancy are controversial. Consequently, thyrotropin (TSH) cutoff-values for pregnancy are continuously a subject for debate. In subclinical hypothyroidism, altered levels of thyroid hormones may affect mitochondrial function.Objectives were i) to analyze thyroid hormone levels in offspring of women with and without subclinical hypothyroidism ii) to analyze mitochondrial "robustness" in terms of MTG/TMRM ratio in pregnant women and their offspring in relation to thyroid function and iii) to perform differentiate analyses on different TSH thresholds to determine the importance of cutoff-values to results.Pregnant women were included by blood collections prior to a planned cesarean section, and cord samples were collected after delivery. Thyroid status (analyzed by Siemens Healthcare Diagnostics by an electrochemical luminescent immunoassay based on LOCI-technology) grouped the women and their offspring in euthyroid or subclinical hypothyroid, with groups established from previous recommended third-trimester cutoff-value (TSH > 3.0 mIU/L) and the recently recommended cutoff-value in Denmark (TSH > 3.7 mIU/L). Flow cytometric measurements of mitochondrial function in mononuclear blood cells with the fluorophores TetraMethylRhodamine Methyl Ester (TMRM) and Mitotracker Green (MTG) were used to evaluate mitochondrial robustness as the MTG/TMRM ratio.No significant differences in mitochondrial robustness between euthyroid and subclinical hypothyroid cohorts were observed, irrespective of TSH-cutoff applied. Maternal and cord MTG/TMRM ratios were positively correlated. Cord-TSH was elevated in subclinical hypothyroid offspring, independent of TSH cutoff applied. Cord-TSH was associated with maternal TSH-level, maternal smoking and cord arterial-pH.
Collapse
Affiliation(s)
- Julie Kristine Guldberg Stryhn
- Department of Gynecology and Obstetrics, Slagelse Hospital, Slagelse, Denmark
- Mitochondria Research Unit, Naestved Hospital, Naestved, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jacob Larsen
- Mitochondria Research Unit, Naestved Hospital, Naestved, Denmark
- Department of Clinical Pathology, Roskilde Hospital, Roskilde, Denmark
| | - Palle Lyngsie Pedersen
- Mitochondria Research Unit, Naestved Hospital, Naestved, Denmark
- Department of Clinical Biochemistry, Naestved Hospital, Naestved, Denmark
| | - Peter Haulund Gæde
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Department of Internal Medicine, Slagelse Hospital, Slagelse, Denmark
| |
Collapse
|
4
|
Page L, Younge N, Freemark M. Hormonal Determinants of Growth and Weight Gain in the Human Fetus and Preterm Infant. Nutrients 2023; 15:4041. [PMID: 37764824 PMCID: PMC10537367 DOI: 10.3390/nu15184041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
The factors controlling linear growth and weight gain in the human fetus and newborn infant are poorly understood. We review here the changes in linear growth, weight gain, lean body mass, and fat mass during mid- and late gestation and the early postnatal period in the context of changes in the secretion and action of maternal, placental, fetal, and neonatal hormones, growth factors, and adipocytokines. We assess the effects of hormonal determinants on placental nutrient delivery and the impact of preterm delivery on hormone expression and postnatal growth and metabolic function. We then discuss the effects of various maternal disorders and nutritional and pharmacologic interventions on fetal and perinatal hormone and growth factor production, growth, and fat deposition and consider important unresolved questions in the field.
Collapse
Affiliation(s)
- Laura Page
- Division of Pediatric Endocrinology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Noelle Younge
- Neonatology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Michael Freemark
- Division of Pediatric Endocrinology, Duke University Medical Center, Durham, NC 27710, USA;
- The Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC 27710, USA
| |
Collapse
|
5
|
Coiffier O, Nakiwala D, Rolland M, Malatesta A, Lyon-Caen S, Chovelon B, Faure P, Sophie Gauchez A, Guergour D, Sakhi AK, Sabaredzovic A, Thomsen C, Pin I, Slama R, Corne C, Philippat C. Exposure to a mixture of non-persistent environmental chemicals and neonatal thyroid function in a cohort with improved exposure assessment. ENVIRONMENT INTERNATIONAL 2023; 173:107840. [PMID: 36857904 DOI: 10.1016/j.envint.2023.107840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND In vitro and toxicological studies have shown that non-persistent environmental chemicals can perturb thyroid hormone homeostasis. Epidemiological studies with improved exposure assessment (i.e., repeated urine samples) are needed to evaluate effects of these compounds, individually or as a mixture, in humans. We studied the associations between prenatal exposure to non-persistent environmental chemicals and neonatal thyroid hormones. METHODS The study population consisted of 442 mother-child pairs from the French SEPAGES mother-child cohort recruited between July 2014 and July 2017. For each participant, four parabens, five bisphenols, triclosan, triclocarban, benzophenone-3 as well as metabolites of phthalates and of di(isononyl)cyclohexane-1,2-dicarboxylate were assessed in two pools of repeated urine samples (median: 21 spot urines per pool), collected in the 2nd and 3rd trimesters of pregnancy, respectively. Thyroid stimulating hormone (TSH) and total thyroxine (T4) levels were determined in newborns from a heel-prick blood spot. Maternal iodine and selenium were assessed in urine and serum, respectively. Adjusted linear regression (uni-pollutant model) and Bayesian Kernel Machine Regression (BKMR, mixture model) were applied to study overall and sex-stratified associations between chemicals and hormone concentrations. RESULTS Interaction with child sex was detected for several compounds. Triclosan, three parabens, and one phthalate metabolite (OH-MPHP) were negatively associated with T4 among girls in the uni-pollutant model. BKMR also suggested a negative association between the mixture and T4 in girls, whereas in boys the association was positive. The mixture was not linked to TSH levels, and for this hormone the uni-pollutant model revealed associations with only a few compounds. CONCLUSION Our study, based on repeated urine samples to assess exposure, showed that prenatal exposure to some phenols and phthalates disturb thyroid hormone homeostasis at birth. Furthermore, both uni-pollutant and mixture models, suggested effect modification by child sex, while, to date underlying mechanisms for such sex-differences are not well understood.
Collapse
Affiliation(s)
- Ophélie Coiffier
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, 38000 Grenoble, France
| | - Dorothy Nakiwala
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, 38000 Grenoble, France
| | - Matthieu Rolland
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, 38000 Grenoble, France
| | - Andres Malatesta
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, 38000 Grenoble, France
| | - Sarah Lyon-Caen
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, 38000 Grenoble, France
| | - Benoît Chovelon
- Département de Pharmacochimie Moléculaire, Université Grenoble Alpes, CNRS, UMR 5063, F-38041 Grenoble, France; Service de Biochimie SB2TE, Institut de Biologie et Pathologie CHU Grenoble Alpes, France
| | - Patrice Faure
- Département de Pharmacochimie Moléculaire, Université Grenoble Alpes, CNRS, UMR 5063, F-38041 Grenoble, France; Service de Biochimie SB2TE, Institut de Biologie et Pathologie CHU Grenoble Alpes, France
| | - Anne Sophie Gauchez
- Service de Biochimie SB2TE, Institut de Biologie et Pathologie CHU Grenoble Alpes, France
| | - Dorra Guergour
- Service de Biochimie SB2TE, Institut de Biologie et Pathologie CHU Grenoble Alpes, France
| | | | | | | | - Isabelle Pin
- Pediatric Department, Grenoble University Hospital, 38700 La Tronche, France
| | - Rémy Slama
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, 38000 Grenoble, France
| | - Christelle Corne
- Service de Biochimie SB2TE, Institut de Biologie et Pathologie CHU Grenoble Alpes, France
| | - Claire Philippat
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, 38000 Grenoble, France.
| |
Collapse
|
6
|
González Martínez S, Prieto García B, Escudero Gomis AI, Delgado Álvarez E, Menéndez Torre EL. Neonatal TSH as a marker of iodine nutrition status. Effect of maternal ioduria and thyroid function on neonatal TSH. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2022; 97:375-382. [PMID: 36241542 DOI: 10.1016/j.anpede.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/12/2022] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Neonatal thyroid stimulating hormone (nTSH) is a marker of iodine nutrition status in the population. The WHO considers a prevalence of less than 3% of nTSH levels greater than 5 mIU/L in samples obtained within 72h from birth indicative of iodine sufficiency. The aim of this study was to determine the prevalence of nTSH levels greater than 5 mIU/L in an iodine-sufficient population and its association with maternal, neonatal and obstetric factors. MATERIALS AND METHODS A total of 243 pregnant women were recruited between May and June 2017 in our health area. A questionnaire of iodine intake was administered, in addition to determination of ioduria, thyroid function and autoimmunity in the first trimester of gestation. We analysed nTSH levels in samples collected between 48 and 72h post birth and other obstetric and neonatal factors. RESULTS The mean nTSH level (standard deviation) was 2.43 (1.68 mIU/L), with 7.8% of neonates having levels greater than 5 mIU/L. The highest nTSH levels corresponded to neonates of mothers with insufficient ioduria (P = 0.021) or TSH levels greater than 2.5 mIU/L, in both the case of negative (P = 0.049) and positive (P = 0.006) thyroid autoimmunity results. Maternal ioduria less than 150 μg/L was a risk factor for nTSH levels greater than 5 mIU/L (3.70 [1.06-14.60]; P = 0.046), while a neonatal weight of 2500 g or greater was a protective factor (0.14 [0.02-1.00]; P = 0.038). CONCLUSIONS The prevalence of nTSH levels greater than 5 mIU/L in our health area was high based on the WHO recommendations. Maternal iodine deficiency was associated with a higher risk of nTSH levels greater than 5 mIU/L. Given that nTSH is currently measured before 72h post birth, we need new cut-off points to keep on using nTSH as a marker of iodine nutritional status.
Collapse
Affiliation(s)
- Silvia González Martínez
- Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, Spain; Grupo de investigación en Endocrinología, Nutrición, Diabetes y Obesidad (ENDO), Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain.
| | - Belén Prieto García
- Servicio de Bioquímica Clínica, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Elías Delgado Álvarez
- Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, Spain; Grupo de investigación en Endocrinología, Nutrición, Diabetes y Obesidad (ENDO), Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Facultad de Medicina, Universidad de Oviedo, Oviedo, Spain
| | - Edelmiro Luis Menéndez Torre
- Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, Spain; Grupo de investigación en Endocrinología, Nutrición, Diabetes y Obesidad (ENDO), Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Facultad de Medicina, Universidad de Oviedo, Oviedo, Spain
| |
Collapse
|
7
|
Nakiwala D, Noyes PD, Faure P, Chovelon B, Corne C, Gauchez AS, Guergour D, Lyon-Caen S, Sakhi AK, Sabaredzovic A, Thomsen C, Pin I, Slama R, Philippat C. Phenol and Phthalate Effects on Thyroid Hormone Levels during Pregnancy: Relying on In Vitro Assays and Adverse Outcome Pathways to Inform an Epidemiological Analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:117004. [PMID: 36350136 PMCID: PMC9645207 DOI: 10.1289/ehp10239] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 08/01/2022] [Accepted: 10/07/2022] [Indexed: 05/29/2023]
Abstract
BACKGROUND Studies characterizing associations between phenols, phthalates and thyroid hormones during pregnancy produce inconsistent results. This divergence may be partly attributable to false positives due to multiple comparison testing of large numbers of chemicals, and measurement error as studies rely on small numbers of biospecimens despite high intra-individual variability in urinary chemical metabolite concentrations. OBJECTIVES This study employs a priori chemical filtering and expanded urinary biomonitoring to evaluate associations between phenol/phthalate exposures and serum thyroid hormones assessed during pregnancy. METHODS A two-tiered approach was implemented: a) In vitro high-throughput screening results from the ToxCast/Tox21 database, as informed by a thyroid Adverse Outcome Pathway network, were evaluated to select phenols/phthalates with activity on known and putative molecular initiating events in the thyroid pathway; and b) Adjusted linear regressions were used to study associations between filtered compounds and serum thyroid hormones measured in 437 pregnant women recruited in Grenoble area (France) between 2014 and 2017. Phenol/phthalate metabolites were measured in repeated spot urine sample pools (median: 21 samples/women). RESULTS The ToxCast/Tox21 screening reduced the chemical set from 16 to 13 and the associated number of statistical comparisons by 19%. Parabens were negatively associated with free triiodothyronine (T3) and the T3/T4 (total thyroxine) ratio. Monobenzyl phthalate was positively associated with total T4 and negatively with the T3/T4 ratio. Effect modification by iodine status was detected for several compounds (among them ΣDEHP and mono-n-butyl phthalate) that were associated with some hormones among women with normal iodine levels. CONCLUSION For these chemicals, screening for compounds with an increased likelihood for thyroid-related effects and relying on repeated urine samples to assess exposures improved the overall performance of multichemical analyses of thyroid disruption. This approach may improve future evaluations of human data for the thyroid pathway with implication for fetal health and may serve as a model for evaluating other toxicity outcomes. https://doi.org/10.1289/EHP10239.
Collapse
Affiliation(s)
- Dorothy Nakiwala
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), Institut national de la santé et de la recherche médicale (Inserm) U1209, Centre national de la recherche scientifique (CNRS) UMR 5309, Université Grenoble Alpes, Grenoble, France
| | - Pamela D. Noyes
- Center for Public Health and Environmental Assessment, Office of Research and Development (ORD), U.S. Environmental Protection Agency, Washington, District of Columbia, USA
| | - Patrice Faure
- Service de Biochimie SB2TE, Institut de Biologie et Pathologie CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Benoît Chovelon
- Service de Biochimie SB2TE, Institut de Biologie et Pathologie CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
- Département de Pharmacochimie Moleculaire, CNRS, UMR 5063, Université Grenoble Alpes, Grenoble, France
| | - Christelle Corne
- Service de Biochimie SB2TE, Institut de Biologie et Pathologie CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Anne Sophie Gauchez
- Service de Biochimie SB2TE, Institut de Biologie et Pathologie CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Dorra Guergour
- Service de Biochimie SB2TE, Institut de Biologie et Pathologie CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Sarah Lyon-Caen
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), Institut national de la santé et de la recherche médicale (Inserm) U1209, Centre national de la recherche scientifique (CNRS) UMR 5309, Université Grenoble Alpes, Grenoble, France
| | - Amrit K. Sakhi
- Department of Food Safety, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Cathrine Thomsen
- Department of Food Safety, Norwegian Institute of Public Health, Oslo, Norway
| | - Isabelle Pin
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), Institut national de la santé et de la recherche médicale (Inserm) U1209, Centre national de la recherche scientifique (CNRS) UMR 5309, Université Grenoble Alpes, Grenoble, France
- Pediatric Department, Grenoble University Hospital, La Tronche, France
| | - Rémy Slama
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), Institut national de la santé et de la recherche médicale (Inserm) U1209, Centre national de la recherche scientifique (CNRS) UMR 5309, Université Grenoble Alpes, Grenoble, France
| | - Claire Philippat
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), Institut national de la santé et de la recherche médicale (Inserm) U1209, Centre national de la recherche scientifique (CNRS) UMR 5309, Université Grenoble Alpes, Grenoble, France
| |
Collapse
|
8
|
Effect of Maternal Triclosan Exposure on Neonatal Thyroid-Stimulating Hormone Levels: A Cross-Sectional Study. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:3082304. [PMID: 36213011 PMCID: PMC9534696 DOI: 10.1155/2022/3082304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 08/11/2022] [Accepted: 09/03/2022] [Indexed: 11/17/2022]
Abstract
Objective This study is aimed at assessing the relationship between maternal urinary triclosan (uTCS) exposure and the thyroid-stimulating hormone (TSH) level of infant cord blood. Methods This cross-sectional study was carried out in 2019-2020 in Isfahan, Iran, and 99 pregnant women participated in the study. Urine samples were collected after the 28th week of pregnancy, and the concentration of TCS was measured using GC/MS. The cord blood levels of TSH (CBL-TSH) were measured. The association between uTCS and CBL-TSH was examined based on the general linear model. Results TCS was detected (≥0.01 ng/mL) in 100% of the urine samples, with the interquartile range (25%-75%) of uTCS levels 0.6-6.23 μg/g Cr. uTCS was not associated with CBL-TSH after adjustment for covariates. A significant relationship was observed between CBL-TSH of neonates born to mothers who had given birth only once compared to mothers who had given birth twice or more times. Conclusions Maternal exposure to TCS did not affect the infant CBL-TSH. However, the high concentrations of TCS in maternal urinary samples indicate the necessity of more precise regulations to decrease the use of this chemical in the industry and increase public awareness about using TCS-free compounds.
Collapse
|
9
|
TSH neonatal como marcador del estado de nutrición de yodo. Influencia de la yoduria y la función tiroidea maternas sobre la TSH neonatal. An Pediatr (Barc) 2022. [DOI: 10.1016/j.anpedi.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
10
|
Verma NR, Naik G, Patel S, Padhi P, Naik T, Nanda R. A detailed observational study of maternal and neonatal variables affecting the thyroid-stimulating hormone levels in neonates. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2021. [DOI: 10.1186/s43054-021-00080-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Thyroid hormones are essential for fetal growth and the central nervous system development. Thyroid-stimulating hormone (TSH) is the key regulatory hormone. Their levels are quite dynamic in the perinatal period and are influenced by multiple factors. These factors should be taken into consideration during newborn screening. This study aimed to observe the impact of maternal and neonatal factors on neonatal TSH status.
Results
Neonatal TSH (nTSH) depicted a positive correlation with parity (p = 0.066) while negative correlation recorded with maternal blood haemoglobin (p = 0.007) among maternal factors.
New-born length (p = 0.027) and birth weight (p < 0.001) exhibited a negative correlation with nTSH among neonatal factors.
Conclusions
This study concludes that among all the maternal and neonatal factors, birth weight shows the most influence on nTSH. However, the effect may be compounded by other factors. As these risk elements rarely occur singly, it is often difficult to find the exposure which confer the risk on children. These factors should be considered while interpreting the result of the screening program.
Collapse
|
11
|
Ramezani Tehrani F, Nazarpour S. Delivery factors and neonatal thyroid hormone levels: a systematic review. J Pediatr Endocrinol Metab 2021; 34:821-833. [PMID: 33882204 DOI: 10.1515/jpem-2020-0740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/28/2021] [Indexed: 12/18/2022]
Abstract
Postnatal thyroid hormone changes enable the neonate to be adapted for postnatal life. Several factors can affect this adaption. In this review, we summarized the studies that reported the association among the delivery factors and neonatal thyroid hormones and thyroid stimulating hormone. A comprehensive literature search was performed in PubMed, Web of Science, and Scopus up to March 2020, to identify the studies investigating the relationship between delivery factors, especially the mode of delivery and labor pain, and neonatal thyroid hormones and TSH. Finally, in this review study, of 157 articles obtained in the initial search, 25 eligible studies were reviewed. Various maternal, fetal/neonatal, and obstetric factors affected neonatal TSH and thyroid hormones. Among various influencing factors, mode of delivery, labor pains, and duration of labor have a strong relationship with neonatal thyroid hormones and need to be considered for interpretation of neonatal thyroid status. The majority of the studies revealed that vaginal deliveries (instrumental or natural) lead to higher levels of cord TSH compared to elective cesarean section. This can be explained by the increased secretion of catecholamine during labor. It has been suggested that blood TSH and thyroid hormone levels are affected by perinatal stress events such as maternal anxiety, labor pains, fetal distress, and other stimulants of the catecholamine response. These changes may act as the trigger to increase thyroid hormone levels for adapting of neonates in the first hours after birth. This assumption needs to be re-evaluated by performing comprehensive and well-designed studies.
Collapse
Affiliation(s)
- Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sima Nazarpour
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Midwifery, College of Medical Sciences, Varamin-Pishva Branch, Islamic Azad University, Tehran, Iran
| |
Collapse
|
12
|
Karaoglan M, İşbilen E. The role of placental iodine storage in the neonatal thyroid stimulating hormone surge: iodine as a driving force to adapt the terrestrial life. J Endocrinol Invest 2021; 44:1041-1052. [PMID: 32860210 DOI: 10.1007/s40618-020-01399-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Iodine plays a pivotal role in adaptation during the transition from intrauterine to extrauterine life. Although it is well known that the placenta plays a role in iodine storage, a relationship between the neonatal thyroid stimulating hormone (TSH) peak and placental iodine concentration has not been established. This study focuses on the role of placental iodine concentration in the TSH surge after delivery. MATERIALS AND METHODS This study included 42 mothers and their newborns, none of whom had perinatal risk factors. The following samples were collected to analyze iodine: placental tissue, amniotic fluid (AF), and 24-h maternal urine. Blood was drawn from the umbilical cord (uc), newborns (at the 1st-24th hours), and mothers (at 1st hour) to analyze the following hormones: TSH, freeT4/T3(fT4/fT3), human chorionic gonadotrophin (hCG), prolactin (PRL), follicle stimulating hormone (FSH), luteinizing hormone (LH), and cortisol. RESULTS The mean iodine levels of placental tissue, AF, and 24-h maternal urine were as follows: 29.06 ± 45.88 μg/kg, 182.80 ± 446.51 µg/L, and 498.35 ± 708.34 µg/L, respectively. The mean TSH and hCG values were 32.41 ± 13.96mIU/ml and 30.66 ± 18.55mIU/ml, respectively, at the 1st hour. Placental iodine had strong, very strong, and weak negative correlations with TSH, hCG, and PRL, respectively (rTSH = - 0.763, p < 0.001;rHCG = - 0.919, p < 0.001; rPRL = - 0.312, p = 0.044). CONCLUSION This study showed that the placental iodine level was inversely correlated with neonatal TSH, hCG, and PRL. It indicates that placental iodine concentration is an efficient driving force shaping the dynamic pattern of the neonatal TSH peak in addition to hCG and PRL surges, which reflects the adaptive effort in the transition from intrauterine to extrauterine life.
Collapse
Affiliation(s)
- M Karaoglan
- Department of Pediatric Endocrinology, Gaziantep University, Faculty of Medicine, 27070, Gaziantep, Turkey.
| | - E İşbilen
- Department of Biochemistry, Gaziantep University, Faculty of Medicine, Gaziantep, Turkey
| |
Collapse
|
13
|
Deziel NC, Zhang Y, Wang R, Wiemels JL, Morimoto L, Clark CJ, Metayer C, Ma X. Birth Characteristics and Risk of Pediatric Thyroid Cancer: A Population-Based Record-Linkage Study in California. Thyroid 2021; 31:596-606. [PMID: 32912083 PMCID: PMC8195873 DOI: 10.1089/thy.2020.0217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Incidence rates of thyroid cancer in children and young adults (age 0-19 years) have nearly doubled over a recent 15-year period in the United States. Children with thyroid cancer may require long-term therapy and surveillance and are at greater risk for second primary malignancies. High-dose exposure to ionizing radiation is the only known nongenetic risk factor; the vast majority of cases have an unknown etiology. Methods: We conducted a population-based nested case-control study to evaluate the relationship between a range of birth characteristics and the risk of pediatric thyroid cancer. Using linked birth records and cancer registry data from California, we included 1012 cases who were diagnosed with first primary thyroid cancer at the age of 0-19 years from 1988 to 2015 and 50,600 birth-year matched controls (1:50 case to control ratio). We estimated adjusted odds ratios (OR) and 95% confidence intervals (CI) by using multivariable logistic regression models applied to the full population and stratified by thyroid cancer subtypes (papillary and follicular), race/ethnicity (white and Hispanic), and age at diagnosis (0-14 and 15-19 years). Results: Hispanic ethnicity (OR: 1.20 [CI 1.01-1.42]), higher birth weight (OR: 1.11 [CI 1.04-1.18] per 500g), and higher maternal education (13-15 years OR: 1.35 [CI 1.09-1.68], 16+ years OR: 1.35 [CI 1.07-1.71]) were associated with an increased risk of pediatric thyroid cancer, while male sex (OR: 0.21 [CI 0.18-0.25]) and higher birth order (third or higher OR: 0.81 [CI 0.68-0.98]) were associated with a decreased risk. Some heterogeneity was observed across subtype, most notably an elevated OR with higher birth order for follicular thyroid cancer, in contrast to the reduced risk for this category among papillary thyroid cancer cases (p-value for interaction = 0.01). Hispanic ethnicity was a risk factor for papillary, but not follicular thyroid cancer (p-value for interaction = 0.07). Conclusions: In this population-based study of birth characteristics and pediatric thyroid cancer, we identified several important risk factors for pediatric thyroid cancer, including female sex, Hispanic ethnicity, higher birth weight, higher maternal educational attainment, and lower birth order. Our data provide new areas for replication and investigation of biological mechanisms for this poorly understood malignancy.
Collapse
Affiliation(s)
- Nicole C. Deziel
- Department of Environmental Health Sciences and Yale School of Public Health, New Haven, Connecticut, USA
- Address correspondence to: Nicole C. Deziel, PhD, Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT 06510, USA
| | - Yawei Zhang
- Department of Environmental Health Sciences and Yale School of Public Health, New Haven, Connecticut, USA
- Section of Surgical Outcomes and Epidemiology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Rong Wang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
| | - Joseph L. Wiemels
- Center for Genetic Epidemiology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
| | - Libby Morimoto
- Department of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Cassandra J. Clark
- Department of Environmental Health Sciences and Yale School of Public Health, New Haven, Connecticut, USA
| | - Catherine Metayer
- Department of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
| |
Collapse
|
14
|
Luan M, Liang H, Fang G, Wang Z, Su X, Chen A, Miao M, Yuan W. Association Between Neonatal Thyroid Function and Anogenital Distance from Birth to 48 Months of Age. Front Endocrinol (Lausanne) 2021; 12:736505. [PMID: 34566898 PMCID: PMC8456038 DOI: 10.3389/fendo.2021.736505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Evidence from animal studies has indicated that neonatal thyroid function is vital for the reproductive development. Anogenital distance (AGD), a sensitive biomarker of the fetal hormonal milieu, can be used to predict adult reproductive disorders. However, few human studies have examined the association between neonatal thyroid function and AGD. We aimed to explore their associations in a birth cohort study. METHODS Concentrations of thyroid stimulating hormone (TSH) and thyroid hormones (THs), including total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), and free thyroxine (FT4) were measured in cord plasma in the Shanghai-Minhang Birth Cohort. The offspring AGD (AGDAP [anus-penis] and AGDAS [anus-scrotum] for boys and AGDAC [anus-clitoris] and AGDAF [anus-fourchette] for girls), body weight and anogenital index (AGI = AGD/weight [mm/kg]) were obtained at each follow-up visit. In total, 344 children (194 boys and 150 girls) with cord plasma concentrations of THs and TSH and at least one AGD measurement at birth and at 6, 12, and 48 months of age were included. Multiple linear regression and generalized estimating equation (GEE) models were used to examine the associations of cord plasma concentrations of THs and TSH with AGI. RESULTS Multiple linear regression models showed inverse associations of TT4, FT3, and FT4 with female AGI, although statistical significance was only reached at birth, 6 and 48 months of age. These associations were also found in GEE models: higher TT4 and FT4 concentrations were associated with lower AGIAC (TT4: β = -0.27, 95% CI: -0.50, -0.03 for middle vs. lowest tertile; FT4: β = -0.38, 95% CI: -0.61, -0.16 for middle and β = -0.30, 95% CI: -0.55, -0.04 for highest vs. lowest tertile). Besides, girls with the highest tertile of FT3 concentrations had lower AGIAF than those with the lowest tertile (the highest vs. lowest tertile: β = -0.22, 95% CI: -0.36, -0.08). Positive associations between TSH and AGI at birth and at 12 months of age were observed in boys. CONCLUSIONS This study provides further evidence on the effects of neonatal thyroid function on reproductive development at an early life stage.
Collapse
Affiliation(s)
- Min Luan
- National Health Commission (NHC) Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), School of Public Health, Fudan University, Shanghai, China
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Hong Liang
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Guanghong Fang
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Ziliang Wang
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Xiujuan Su
- Clinical Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Maohua Miao
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
- *Correspondence: Maohua Miao,
| | - Wei Yuan
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| |
Collapse
|
15
|
Tan KML, Chu AHY, Loy SL, Rajadurai VS, Ho CKM, Chong YS, Karnani N, Lee YS, Yap FKP, Chan SY. Association of Cord Blood Thyroid-Stimulating Hormone Levels with Maternal, Delivery and Infant Factors. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.2020471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Abstract
Introduction: This study examined maternal, delivery and infant factors associated with
cord thyroid-stimulating hormone (TSH) concentrations in an Asian population.
Methods: The Growing Up in Singapore Towards healthy Outcomes (GUSTO) study is
a mother–offspring birth cohort from 2 major hospitals in Singapore. Cord serum TSH
was measured using the Abbott ARCHITECT TSH Chemiluminescent Microparticle
Immunoassay and the ADVIA Centaur TSH-3 Immunoassay. After excluding infants with
a maternal history of thyroid disease, screening cord TSH results from 604 infants were
available for multivariable regression analysis in relation to the factors of interest.
Results: Babies born by vaginal delivery had significantly higher cord serum TSH
concentrations than babies born by caesarean section. Cord serum TSH concentrations
differed significantly by measurement method. There was no association of cord TSH
concentrations with ethnicity, sex, birth weight, gestational age, maternal body mass index,
gestational weight gain, gestational diabetes mellitus status and other maternal, delivery
and infant factors studied.
Conclusion: Interpretation of cord serum TSH results may need to take into account mode
of delivery and measurement method.
Keywords: Cord blood, Growing Up in Singapore Towards healthy Outcomes,
GUSTO, perinatal
Collapse
Affiliation(s)
- Karen ML Tan
- Agency for Science, Technology and Research, Singapore
| | - Anne HY Chu
- Agency for Science, Technology and Research, Singapore
| | | | | | | | | | | | - Yung Seng Lee
- Agency for Science, Technology and Research, Singapore
| | | | | |
Collapse
|
16
|
Yamazaki K, Itoh S, Araki A, Miyashita C, Minatoya M, Ikeno T, Kato S, Fujikura K, Mizutani F, Chisaki Y, Kishi R. Associations between prenatal exposure to organochlorine pesticides and thyroid hormone levels in mothers and infants: The Hokkaido study on environment and children's health. ENVIRONMENTAL RESEARCH 2020; 189:109840. [PMID: 32979988 DOI: 10.1016/j.envres.2020.109840] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/19/2020] [Accepted: 06/15/2020] [Indexed: 06/11/2023]
Abstract
Organochlorine pesticides (OCPs) are environmental contaminants with potentially adverse effects on neurodevelopment. Previous findings on the association between prenatal exposure to OCPs and the maternal or infant thyroid hormone system are inconsistent. Moreover, the influence of exposure to multiple OCPs and other chemical compounds is not clearly understood. Our study therefore aimed to examine the association between OCP exposure and both maternal and infant thyroid hormone systems. We also explored multiple exposure effects of OCPs and the influence of each compound using weighted quantile sum (WQS) methods. The study population included 514 participants in the Hokkaido study, recruited from 2002 to 2005 at one hospital in Sapporo, Japan. To quantify 29 OCPs, maternal blood samples were analyzed using gas chromatography/mass spectrometry. Blood samples for measuring thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels were obtained from mothers during the early gestational stage (mean 11.4 weeks), and from infants between 7 and 43 days of age. The data of 333 mother child pairs with OCP and thyroid hormone measurements were included in the final analyses. Multivariate regression models showed a negative association between maternal FT4 and levels of o,p'-dichlorodiphenyldichloroethylene (DDE), o,p'-dichlorodiphenyltrichloroethane (DDT), and dieldrin. The WQS analysis showed that o,p'-DDT (48.6%), cis-heptachlorepoxide (22.8%), dieldrin (15.4%) were the primary contributors to the significant multiple exposure effect of OCPs on maternal FT4. For infants, we found a positive association between FT4 and cis-nonachlor and mirex. The most contributory compounds in the multiple exposure effect were trans-nonachlor (27.1%) and cis-nonachlor (13.8%), while several compounds contributed to the WQS via small weights (0.4-9.1%). These results indicate that OCPs, even at very low levels, may influence maternal and child thyroid hormone levels, which could modulate child development.
Collapse
Affiliation(s)
- Keiko Yamazaki
- Center for Environmental and Health Sciences, Hokkaido University, North 12 West 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, North 12 West 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Atsuko Araki
- Center for Environmental and Health Sciences, Hokkaido University, North 12 West 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, North 12 West 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Machiko Minatoya
- Center for Environmental and Health Sciences, Hokkaido University, North 12 West 7, Kita-ku, Sapporo, 060-0812, Japan; Department of Health Sciences, School of Medicine, Hokkaido University, North 12 West 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Tamiko Ikeno
- Center for Environmental and Health Sciences, Hokkaido University, North 12 West 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Shizue Kato
- Department of Public Health Sciences, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan
| | | | - Futoshi Mizutani
- Institute of Environmental Ecology, IDEA Consultants, Inc., 1334-5, Riemon, Yaizu, Shizuoka, Japan
| | - Yoichi Chisaki
- Institute of Environmental Ecology, IDEA Consultants, Inc., 1334-5, Riemon, Yaizu, Shizuoka, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, North 12 West 7, Kita-ku, Sapporo, 060-0812, Japan.
| |
Collapse
|
17
|
Al Jafari M, Jose S, Al Senani A. Demographic Features and Etiology of Congenital Hypothyroidism at the National Diabetes and Endocrine Center in Oman from 2004 to 2016. Oman Med J 2020; 35:e171. [PMID: 33062310 PMCID: PMC7533048 DOI: 10.5001/omj.2020.113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 03/25/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Congenital hypothyroidism (CH) is the most common endocrine disorder in neonates as well as one of the few preventable causes of severe learning difficulties. Early screening, diagnosis, and treatment are mandatory to prevent later sequelae. We sought to determine the demographic and the clinical features of CH in Oman. METHODS We conducted a retrospective cross-sectional study, including all Omani children newly diagnosed with CH from January 2004 to December 2016 followed at the National Diabetes and Endocrine Center at the Royal Hospital. Those with transient hypothyroidism were excluded from the study. Data collection involved demographic data, clinical manifestations, lab investigations, thyroid scan results, and initiation date of the thyroxine (T4). RESULTS A total of 96 patients were newly diagnosed with CH during the study period. Out of the 96 patients, 43 were males (44.8%), and 53 were females (55.2%), and majority were asymptotic (n = 84; 87.5%). Only 78 patients had a thyroid scan. Among those who did the scan, thyroid dysgenesis was the most common (n = 40, 51.3%), followed by dyshormonogenesis (n = 35; 44.9%) and the least was central hypothyroidism (n = 3; 3.8%). The majority of patients (n = 72; 86.7%) were started on T4 therapy within 30 days of life. The remaining (n = 11; 13.3%) had a delay in starting the treatment due to compliance issues, which led to a developmental delay (p < 0.001). CONCLUSIONS This is the first epidemiological study conducted in Oman that highlights the unique demographic and etiology features of CH. Dyshormonogenesis has a high prevalence in the Omani population compared to other nations. The neurological sequelae in our patients were higher in compression to worldwide prevalence, which was mainly due to delay in starting T4 therapy.
Collapse
Affiliation(s)
- Mohammed Al Jafari
- Department of Pediatrics, Jalan Bani Bu Ali Hospital, Jalan Bani Bu Ali, Oman
- Pediatrics Residency Program, Oman Medical Specialty Board, Muscat, Oman
| | - Sachin Jose
- Research Section, Oman Medical Specialty Board, Muscat, Oman
| | | |
Collapse
|
18
|
Xiao C, Grandjean P, Valvi D, Nielsen F, Jensen TK, Weihe P, Oulhote Y. Associations of Exposure to Perfluoroalkyl Substances With Thyroid Hormone Concentrations and Birth Size. J Clin Endocrinol Metab 2020; 105:dgz147. [PMID: 31665456 PMCID: PMC7112969 DOI: 10.1210/clinem/dgz147] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 10/25/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Adequate thyroid function during pregnancy is essential for optimal fetal growth. Gestational exposure to perfluoroalkyl substances (PFAS) can negatively affect birth size and disrupt maternal and neonatal thyroid function, although the interrelationship is unclear. OBJECTIVE We aimed to quantify the associations between maternal serum-PFAS concentrations and birth weight, birth length, and cranial circumference. We also aimed to estimate associations between PFAS and thyroid hormone (TH) concentrations, thereby elucidating whether THs potentially mediate the associations between PFAS concentrations and birth size. METHODS We studied a population-based prospective cohort of 172 mother-singleton pairs from the Faroe Islands. Twelve PFAS were measured in maternal serum obtained at 34 weeks of gestation. THs were measured in maternal and cord serum. Associations between PFAS concentrations and birth size and TH concentrations were estimated using multivariable linear regressions. Sex-stratified analyses along with a mediation analysis were performed to estimate potential mediating effects of THs in the association between PFAS and birth outcomes. RESULTS Several PFASs were negatively associated with birth weight, length, and head circumference, and a general positive association between maternal serum-PFASs and cord serum-thyroid-stimulating hormone (TSH; also known as thyrotropin) was found. For instance, a doubling in perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) was associated with a 53% (95% CI, 18%-99%) and 40% (95% CI, 8%-81%) increases in TSH concentrations, respectively. There was little evidence of sexually dimorphic associations. Overall, THs were not found to mediate associations between PFASs and birth size. CONCLUSION In this study, several PFASs were negatively associated with birth size and increased THs; however, this did not explain lower birth weight among children exposed to PFAS.
Collapse
Affiliation(s)
- Christina Xiao
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- EHESP-School of Public Health, Sorbonne Paris Cité, Rennes, France
| | - Philippe Grandjean
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Damaskini Valvi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Flemming Nielsen
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Tina Kold Jensen
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Pal Weihe
- The Faroese Hospital System, Tórshavn, Faroe Islands
| | - Youssef Oulhote
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, Massachusetts
| |
Collapse
|
19
|
Di Dalmazi G, Carlucci MA, Semeraro D, Giuliani C, Napolitano G, Caturegli P, Bucci I. A Detailed Analysis of the Factors Influencing Neonatal TSH: Results From a 6-Year Congenital Hypothyroidism Screening Program. Front Endocrinol (Lausanne) 2020; 11:456. [PMID: 32849264 PMCID: PMC7396660 DOI: 10.3389/fendo.2020.00456] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 06/10/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Neonatal thyrotropin (TSH) on dried blood spot (DBS), the most common screening strategy for primary congenital hypothyroidism (CH), is influenced by numerous factors that may hinder a true CH diagnosis. A second test can thus be performed to clarify the initial findings, although its application varies among screening programs. Objectives: The aim of this study was to evaluate the effect of maternal and neonatal factors on neonatal TSH levels and offer practical screening recommendations. Methods: We retrospectively analyzed screening data of 62,132 neonates born in Abruzzo, an Italian region considered mildly iodine deficient, between 2011 and 2016. We then performed a multiple linear regression to model the relationship between TSH (the dependent variable) and 13 independent variables extracted from blood collection cards. Results: Most neonates (53,551 of 62,132, 86%) had normal TSH and no clinical indications for a second screening. A minority (1,423, 2.3%) had elevated TSH in the initial DBS, which was confirmed in 97 cases (7%) on a second screen. The remaining neonates (6,594, 10.6%) had a normal initial TSH but underwent a second test in accordance with screening protocols, and were found to have delayed TSH elevation in 23 cases (0.4%). Those 120 newborns (97 + 23), considered highly suspicious for primary CH, were referred to a pediatrician for confirmatory testing and excluded from subsequent analysis of factors influencing TSH levels. Sex (β regression coefficient, β = 1.11 female to male, 95% CI 1.09, 1.12) and age at collection (β = 0.78 day 5 to days 2-3, 95% CI 0.74, 0.83) affected neonatal TSH, suggesting the utility of specific nomograms. In addition, prematurity (β = 0.85 term to preterm, 95% CI 0.80, 0.91), dopamine use (β = 0.71, 95% CI 0.62, 0.81), and birth weight (β = 1.40 normal vs. very low, 95% CI 1.05, 1.89) strongly influenced neonatal TSH. Conclusions: Neonatal TSH is influenced by several factors supporting the delineation of local sex- and age-adjusted TSH cutoffs, and the universal adoption of a second TSH test in neonates at risk of missed primary CH diagnosis.
Collapse
Affiliation(s)
- Giulia Di Dalmazi
- Section of Endocrinology, Department of Medicine and Aging Science, Center for Advanced Studies and Technology (CAST), G. D'Annunzio University, Chieti-Pescara, Italy
- Department of Medicine and Aging Science, Center for Advanced Studies and Technology (CAST) and Translational Medicine, University of Chieti G. D'Annunzio, Chieti, Italy
- *Correspondence: Giulia Di Dalmazi
| | - Maria Assunta Carlucci
- Section of Endocrinology, Department of Medicine and Aging Science, Center for Advanced Studies and Technology (CAST), G. D'Annunzio University, Chieti-Pescara, Italy
| | - Daniela Semeraro
- Section of Endocrinology, Department of Medicine and Aging Science, Center for Advanced Studies and Technology (CAST), G. D'Annunzio University, Chieti-Pescara, Italy
| | - Cesidio Giuliani
- Section of Endocrinology, Department of Medicine and Aging Science, Center for Advanced Studies and Technology (CAST), G. D'Annunzio University, Chieti-Pescara, Italy
| | - Giorgio Napolitano
- Section of Endocrinology, Department of Medicine and Aging Science, Center for Advanced Studies and Technology (CAST), G. D'Annunzio University, Chieti-Pescara, Italy
| | - Patrizio Caturegli
- Division of Immunology, Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Ines Bucci
- Section of Endocrinology, Department of Medicine and Aging Science, Center for Advanced Studies and Technology (CAST), G. D'Annunzio University, Chieti-Pescara, Italy
| |
Collapse
|
20
|
Kim HR, Jung YH, Choi CW, Chung HR, Kang MJ, Kim BI. Thyroid dysfunction in preterm infants born before 32 gestational weeks. BMC Pediatr 2019; 19:391. [PMID: 31664954 PMCID: PMC6819381 DOI: 10.1186/s12887-019-1792-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 10/17/2019] [Indexed: 11/23/2022] Open
Abstract
Background Thyroid hormones are critical for growth and brain development during the newborn period and infancy. Because of delayed maturation of the hypothalamic-pituitary-thyroid axis in preterm infants, thyroid dysfunction is common, and thyroid stimulating hormone (TSH) elevation is often delayed in preterm infants. The objective of this study was to determine the incidence of thyroid dysfunction requiring levothyroxine treatment and to identify its risk factors in preterm infants. Methods A retrospective cohort study was performed on preterm infants who were born before 32 gestational weeks and admitted to a single tertiary academic center for more than 8 weeks between January 2008 and December 2014. In these infants, serial thyroid function tests (TFTs) measuring serum TSH and free thyroxine (fT4) were routinely performed at 1, 3, and 6 weeks of postnatal age. Results Of the 220 preterm infants enrolled, 180 infants underwent TFTs at 1, 3, and 6 weeks of postnatal age and were included in the study. Of the 180 infants, 35 infants (19.4%) were started on levothyroxine treatment based on the results of serial TFTs. Among the 35 infants who were treated with levothyroxine, 16 infants (45.7%) had normal results on the initial TFT. Three of these 16 infants continued to have normal results on the second TFT. Thyroid dysfunction requiring levothyroxine treatment was significantly associated with maternal pregnancy-induced hypertension (adjusted odds ratio 2.64, 95% confidence interval 1.02–6.81). Conclusions Thyroid dysfunction requiring levothyroxine treatment occurred in nearly one-fifth of preterm infants born before 32 gestational weeks. Nearly half of the preterm infants who were treated with levothyroxine had normal TSH and fT4 levels at 1 week of postnatal age. The findings of the present study suggest that serial TFTs is important to find preterm infants who require levothyroxine treatment.
Collapse
Affiliation(s)
- Hye-Rim Kim
- Department of Pediatrics, Bundang CHA Medical Center, CHA University, Seongnam, Republic of Korea.,Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Hwa Jung
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea. .,Department of Pediatrics, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea.
| | - Chang Won Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Pediatrics, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea
| | - Hye Rim Chung
- Department of Pediatrics, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea
| | - Min-Jae Kang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Beyong Il Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Pediatrics, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea
| |
Collapse
|
21
|
Fan P, Luo ZC, Tang N, Wang W, Liu Z, Zhang J, Ouyang F. Advanced Maternal Age, Mode of Delivery, and Thyroid Hormone Levels in Chinese Newborns. Front Endocrinol (Lausanne) 2019; 10:913. [PMID: 31998241 PMCID: PMC6966407 DOI: 10.3389/fendo.2019.00913] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 12/16/2019] [Indexed: 12/22/2022] Open
Abstract
Objective: Thyroid hormones are essential for fetal growth and neurodevelopment, however, data on cord blood thyroid hormones are sparse in China where maternal age at childbearing is increasing in recent decades. We aimed to assess cord blood levels of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) in full-term Chinese newborns, and examine potential related perinatal factors. Methods: This study included 922 mother-newborn pairs from a prospective birth cohort enrolled in 2012-2013, Shanghai, China. Cord serum concentrations of FT3, FT4, TSH, and TPOAb were measured in newborns. Results: Newborns born via cesarean section had higher cord serum FT3 (mean ± SD: 1.90 ± 1.16 pmol/L) and lower cord serum TSH (5.15 ± 2.60 mIU/L) than those born via vaginal delivery (FT3: 1.62 ± 0.93 pmol/L; TSH: 9.27 ± 6.76 mIU/L). In cesarean section deliveries, the concentration of cord serum FT3 was 0.15 (95%CI: -0.03, 0.33; p = 0.10) pmol/L lower in infants of mothers aged 30-34 years, and 0.57 (95%CI: 0.22, 0.92; p = 0.002) pmol/L lower in infants of mothers ≥35 years compared to infants of mothers <30 years. Large-for-gestational-age (birth weight >90th percentile) was associated with higher TSH (p = 0.02). Similar results were also found in vaginal deliveries. Conclusions: In this Chinese term birth cohort, newborns born via cesarean section had higher cord serum FT3 and lower TSH than those born via vaginal delivery. Advanced maternal age was associated with lower fetal FT3. Further research is needed to understand whether this association may mediate the adverse impact of advanced maternal age on neurodevelopment in early life.
Collapse
Affiliation(s)
- Pianpian Fan
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhong-Cheng Luo
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Obstetrics and Gynecology, Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Ning Tang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiye Wang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiwei Liu
- Department of Neonatology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fengxiu Ouyang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Fengxiu Ouyang ;
| |
Collapse
|
22
|
Pratinidhi S, Poyekar S, Prasad SS, Sardar ZS, Kankariya B, Bhole O. Cord blood Thyroid Stimulating Hormone Level - and the influence of perinatal and other factors on it. ACTA ACUST UNITED AC 2019. [DOI: 10.7199/ped.oncall.2019.31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
23
|
Normative Data for Thyroid Stimulating Hormone for Screening of Congenital Hypothyroidism. Indian J Pediatr 2018; 85:941-947. [PMID: 29479653 DOI: 10.1007/s12098-017-2550-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 11/17/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To generate normative data for thyroid stimulating hormone (TSH) levels in heel prick samples collected from newborns from 24 h to 7 d of age. METHODS Five regional laboratories were designated as the testing laboratories. Dried blood spots (DBS) from babies (> or = 34 wk of gestation) were collected by heel prick at least after 24 h and within seven days after birth. TSH estimation was done using time resolved fluoroimmunoassay. Values above 20mIU/L were labelled as presumptive positive. Hour interval specific normative data was categorized at 6 h intervals. Another category placed was division into 24-72 h category, 73-96 h and 99-168 h. Percentile charts were calculated across these specified intervals. RESULTS Samples analysed were 104,006 collected cumulatively from the 5 centers. Of the total samples analysed for TSH, 92.8% had values less than 5 mIU/l. When TSH values were interpreted with respect to time, a steady decrease with time was observed. Of the babies' samples, 48,839 were collected between 24 and 48 h, 23,983 between 49 to 72 h and 30,883 were collected after 72 h. The mean TSH concentration demonstrated a steady decline from 24 h to 168 h. It is apparent that 10 mIU/l is the 97.5th percentile value even when corrected for gender, birth weight and age at sampling. Thus 10 mIU/l seems to be the right cutoff beyond which a second sample should be sought. CONCLUSIONS This is the largest series reported with a broader population mix with representations of both urban (including slums) as well as a rural population. As this study excluded preterm babies, the utility of cut offs generated is not applicable to this subset and also to critically sick neonates. However, this study gives a true representation of the normative values for majority of the newborns born at term with weight appropriate for the gestation.
Collapse
|
24
|
Zhang Y, Du C, Wang W, Chen W, Shao P, Wang C, Leng J, Shen J, Tan L, Zhang W. Effect of maternal and neonatal factors on neonatal thyroid stimulating hormone: Results from a population-based prospective cohort study in China. J Trace Elem Med Biol 2018; 49:151-156. [PMID: 29895366 DOI: 10.1016/j.jtemb.2018.05.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/26/2018] [Accepted: 05/08/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Neonatal TSH screening is effective in detecting congenital hypothyroidism and estimating iodine status in a given population, but various factors influence TSH levels. The aim of this study was to evaluate the effect of maternal and neonatal factors on neonatal TSH levels. DESIGN AND SETTING Data were obtained from an ongoing prospective cohort study. A total of 988 pregnant women and their newborn infants participated in the study from April 2015 to May 2017 at Tianjin Maternal and Child Health Center and Tanggu Maternity Hospital in Tianjin, China. Maternal demographic information, including age, height, and parity, was recorded by questionnaire. Fasting blood and urinary samples were collected from all pregnant women. After parturition, information on gestation duration, mode of delivery, neonatal sex, neonatal TSH, neonatal birth weight, and neonatal birth height were recorded. RESULTS Maternal age, maternal BMI, gestation duration, parity, and neonatal birth weight and height were significantly correlated with neonatal TSH (p < 0.05). Quantile regression revealed that maternal age, TSH, FT4, and gestation duration were positively correlated with neonatal TSH level. A logistic regression model identified maternal BMI, TSH, and birth height as risk factors for having neonatal TSH > 5 mIU/L (p < 0.05). CONCLUSION Neonatal TSH levels are dynamic and may be affected by several maternal and neonatal factors including maternal age, TSH, FT4, and birth weight and height. Identification of these confounders is useful for assessing the status of neonatal thyroid development. STRENGTHS AND LIMITATIONS OF THIS STUDY: (1) Iodine deficiency disorder has generally been eliminated, so the median urinary iodine concentration of pregnancy is higher than 150 μg/L even in mildly or moderately iodine deficient areas. (2) Unlike many other studies, which did not consider the complexity of factors or examined only one or two variables, this study used a multivariate model to analyze the data. (3) This study examined numerous high-risk factors in pregnant women and considered the biological interrelation between them. Future studies should consider these confounding factors for neonatal TSH levels and establish a proper neonatal TSH range for monitoring the iodine status of a population or diagnosing congenital hypothyroidism.
Collapse
Affiliation(s)
- Yixin Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Cong Du
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wei Wang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wen Chen
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ping Shao
- Department of Maternal and Child Health, Tianjin Maternal and Child Health Center, Tianjin, China
| | - Chongdan Wang
- Department of Obstetrics, Tanggu Maternity Hospital, Tianjin, China
| | - Junhong Leng
- Department of Maternal and Child Health, Tianjin Maternal and Child Health Center, Tianjin, China
| | - Jun Shen
- Department of Sanitary Chemistry, Tianjin Medical University, Tianjin, China
| | - Long Tan
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wanqi Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.
| |
Collapse
|
25
|
Hippocampus-dependent memory and allele-specific gene expression in adult offspring of alcohol-consuming dams after neonatal treatment with thyroxin or metformin. Mol Psychiatry 2018; 23:1643-1651. [PMID: 28727687 PMCID: PMC5775940 DOI: 10.1038/mp.2017.129] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 05/08/2017] [Accepted: 05/09/2017] [Indexed: 02/06/2023]
Abstract
Fetal alcohol spectrum disorder (FASD), the result of fetal alcohol exposure (FAE), affects 2-11% of children worldwide, with no effective treatments. Hippocampus-based learning and memory deficits are key symptoms of FASD. Our previous studies show hypothyroxinemia and hyperglycemia of the alcohol-consuming pregnant rat, which likely affects fetal neurodevelopment. We administered vehicle, thyroxine (T4) or metformin to neonatal rats post FAE and rats were tested in the hippocampus-dependent contextual fear-conditioning paradigm in adulthood. Both T4 and metformin alleviated contextual fear memory deficit induced by FAE, and reversed the hippocampal expression changes in the thyroid hormone-inactivating enzyme, deiodinase-III (Dio3) and insulin-like growth factor 2 (Igf2), genes that are known to modulate memory processes. Neonatal T4 restored maternal allelic expressions of the imprinted Dio3 and Igf2 in the adult male hippocampus, while metformin restored FAE-caused changes in Igf2 expression only. The decreased hippocampal expression of DNA methyltransferase 1 (Dnmt1) that maintains the imprinting of Dio3 and Igf2 during development was normalized by both treatments. Administering Dnmt1 inhibitor to control neonates resulted in FAE-like deficits in fear memory and hippocampal allele-specific expression of Igf2, which were reversed by metformin. We propose that neonatal administration of T4 and metformin post FAE affect memory via elevating Dnmt1 and consequently normalizing hippocampal Dio3 and Igf2 expressions in the adult offspring. The present results indicate that T4 and metformin, administered during the neonatal period that is equivalent to the third trimester of human pregnancy, are potential treatments for FASD and conceivably for other neurodevelopmental disorders with cognitive deficits.
Collapse
|
26
|
Romano ME, Eliot MN, Zoeller RT, Hoofnagle AN, Calafat AM, Karagas MR, Yolton K, Chen A, Lanphear BP, Braun JM. Maternal urinary phthalate metabolites during pregnancy and thyroid hormone concentrations in maternal and cord sera: The HOME Study. Int J Hyg Environ Health 2018; 221:623-631. [PMID: 29606598 PMCID: PMC5972051 DOI: 10.1016/j.ijheh.2018.03.010] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 03/21/2018] [Accepted: 03/22/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Phthalates, endocrine-disrupting chemicals that are commonly found in consumer products, may adversely affect thyroid hormones, but findings from prior epidemiologic studies are inconsistent. OBJECTIVES In a prospective cohort study, we investigated whether maternal urinary phthalate metabolite concentrations and phthalate mixtures measured during pregnancy were associated with thyroid hormones among pregnant women and newborns. METHODS We measured nine phthalate metabolites [monoethyl phthalate (MEP), mono-n-butyl phthalate, mono-isobutyl phthalate, monobenzyl phthalate (MBzP), and four monoesthers of di(2-ethylhexyl) phthalate] in urine collected at approximately 16 and 26 weeks' gestation among women in the Health Outcomes and Measures of the Environment Study (2003-2006, Cincinnati, Ohio). Thyroid stimulating hormone (TSH) and free and total thyroxine and triiodothyronine were measured in maternal serum at 16 weeks' gestation (n = 202) and cord serum at delivery (n = 276). We used multivariable linear regression to assess associations between individual urinary phthalate metabolites and concentrations of maternal or cord serum thyroid hormones. We used weighted quantile sum regression (WQS) to create a phthalate index describing combined concentrations of phthalate metabolites and to investigate associations of the phthalate index with individual thyroid hormones. RESULTS With each 10-fold increase in 16-week maternal urinary MEP, maternal serum total thyroxine (TT4) decreased by 0.52 μg/dL (95% CI: -1.01, -0.03). For each 10-fold increase in average (16- and 26-week) maternal urinary MBzP, cord serum TSH decreased by 19% (95% CI: -33.1, -1.9). Among mothers, the phthalate index was inversely associated with maternal serum TT4 (WQS beta = -0.60; 95% CI: -1.01, -0.18). Among newborns, the phthalate index was inversely associated with both cord serum TSH (WQS beta = -0.11; 95% CI: -0.20, -0.03) and TT4 (WQS beta = -0.53; 95% CI: -0.90, -0.16). CONCLUSION Our results suggest that co-exposure to multiple phthalates was inversely associated with certain thyroid hormones (TT4 in pregnant women and newborns, and TSH in newborns) in this birth cohort. These findings highlight the need to study chemical mixtures in environmental epidemiology.
Collapse
Affiliation(s)
- Megan E Romano
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
| | - Melissa N Eliot
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - R Thomas Zoeller
- Department of Biology, University of Massachusetts, Amherst, MA, USA
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Kimberly Yolton
- Division of General and Community Pediatrics, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Aimin Chen
- Epidemiology and Biostatistics, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Bruce P Lanphear
- Child and Family Research Institute, BC Children's and Women's Hospital and Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Joseph M Braun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| |
Collapse
|
27
|
Preston EV, Webster TF, Oken E, Claus Henn B, McClean MD, Rifas-Shiman SL, Pearce EN, Braverman LE, Calafat AM, Ye X, Sagiv SK. Maternal Plasma per- and Polyfluoroalkyl Substance Concentrations in Early Pregnancy and Maternal and Neonatal Thyroid Function in a Prospective Birth Cohort: Project Viva (USA). ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:027013. [PMID: 29488882 PMCID: PMC6066354 DOI: 10.1289/ehp2534] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 01/28/2018] [Accepted: 01/30/2018] [Indexed: 05/18/2023]
Abstract
BACKGROUND Prenatal exposure to some per- and polyfluoroalkyl substances (PFASs) may disrupt maternal and neonatal thyroid function, which is critical for normal growth and neurodevelopment. OBJECTIVES We examined associations of PFAS exposure during early pregnancy with maternal and neonatal thyroid hormone levels. METHODS We studied 732 mothers and 480 neonates in Project Viva, a longitudinal prebirth cohort in Boston, Massachusetts. We quantified six PFASs, including perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), and maternal thyroid hormones [thyroxine (T4), Free T4 Index (FT4I), thyroid stimulating hormone (TSH)] in plasma samples collected at a median 9.6 wk gestation and neonatal T4 levels from postpartum heel sticks. We estimated associations of PFAS concentrations with thyroid hormone levels using covariate-adjusted linear regression models and explored effect measure modification by maternal thyroid peroxidase antibody (TPOAb) status and infant sex. RESULTS PFAS concentrations were not associated with maternal T4, but PFOA, perfluorohexane sulfonate (PFHxS), and 2-(N-methyl-perfluorooctane sulfonamido) acetate (MeFOSAA) were inversely associated with maternal FT4I [e.g., -1.87% (95% confidence interval (CI): -3.40, -0.31) per interquartile (IQR) increase in PFOA]. PFAS concentrations [PFOA, PFOS, and perfluorononanoate (PFNA)] were inversely associated with TSH levels in TPOAb-positive women only. Prenatal PFOS, PFOA, and PFHxS concentrations were inversely associated with T4 levels in male [e.g., PFHxS, quartile 4 vs.1: -2.51μg/dL (95% CI: -3.99, -1.04 )], but not female neonates [0.40μg/dL (95% CI: -0.98, 1.79)]. CONCLUSIONS In this study, prenatal exposure to some PFASs during early pregnancy was inversely associated with maternal FT4I and neonatal T4 in male infants. These results support the hypothesis that prenatal exposure to PFASs influences thyroid function in both mothers and infants. https://doi.org/10.1289/EHP2534.
Collapse
Affiliation(s)
- Emma V Preston
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Thomas F Webster
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Deptartment of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute , Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health , Boston, Massachusetts, USA
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Michael D McClean
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Deptartment of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute , Boston, Massachusetts, USA
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Lewis E Braverman
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Xiaoyun Ye
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sharon K Sagiv
- Center for Environmental Research and Children's Health, University of California , Berkeley School of Public Health, Berkeley, California, USA
- Department of Environmental Health, Boston University School of Public Health , Boston, Massachusetts, USA
| |
Collapse
|
28
|
Donald KA, Wedderburn CJ, Barnett W, Hoffman N, Zar HJ, Redei EE, Stein DJ. Thyroid Function in Pregnant Women With Moderate to Severe Alcohol Consumption Is Related to Infant Developmental Outcomes. Front Endocrinol (Lausanne) 2018; 9:294. [PMID: 29951034 PMCID: PMC6008549 DOI: 10.3389/fendo.2018.00294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 05/17/2018] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Fetal alcohol spectrum disorders (FASD) have an estimated global prevalence of 2-5% of births, but prevalence is reported to be as high as 15.5% for FASD in certain high-risk communities in South Africa. Preclinical studies demonstrate that alcohol consumption during pregnancy interferes with thyroid hormone availability and function and negatively impacts exposed offspring. Very little is currently reported on this phenomenon in humans. METHODS This pilot study was embedded in the Drakenstein Child Health Study, a multi-disciplinary longitudinal birth cohort study investigating the early biological and psychosocial determinants of child health in South Africa. Twenty one mothers and their children with moderate-severe prenatal alcohol exposure (PAE) and 19 mothers and their children with no alcohol exposure were investigated. Maternal exposure history and blood samples were collected in mid-pregnancy and analyzed for serum-free thyroxin (FT4), free triiodothyronine (FT3), and thyroid stimulating hormone (TSH). Children were assessed with formally measured growth parameters and development was evaluated using the Bayley III Scales of Infant and Toddler Development (BSID III) at 6 and 24 months of age. RESULTS While there were no significant differences in serum TSH and FT4 between groups, FT3 levels were significantly higher in mothers with moderate-severe prenatal alcohol use. In abstinent pregnant women, levels of FT4 were significantly correlated with infants' scores on cognitive measures at 6 and 24 months of age and with levels of gross motor skills at 24 months. However, in mothers with alcohol use, FT4 levels were not correlated with any cognitive or motor skills, but FT3 levels were significantly associated with scores on children's social-emotional development at 24 months of age. DISCUSSION Thyroid function in PAE is sufficiently disrupted to lead to alterations in serum FT3 levels. The contrast in findings between PAE and abstinent dyads in their association of maternal thyroid function and infant development further suggests that such disruption is present and may contribute to adverse neurodevelopment. Further work is needed to determine the relationship between peripheral thyroid indices during pregnancy and neurodevelopmental outcomes in the context of PAE.
Collapse
Affiliation(s)
- Kirsten A. Donald
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- *Correspondence: Kirsten A. Donald,
| | - Catherine J. Wedderburn
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Whitney Barnett
- Unit on Child and Adolescent Health, South African Medical Research Council (SAMRC), Cape Town, South Africa
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
| | - Nadia Hoffman
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Heather J. Zar
- Unit on Child and Adolescent Health, South African Medical Research Council (SAMRC), Cape Town, South Africa
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
| | - Eva E. Redei
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Unit on Risk and Resilience in Mental Disorders, South African Medical Research Council (SAMRC), Cape Town, South Africa
| |
Collapse
|
29
|
Kayıran SM, Erçin S, Kayıran P, Gursoy T, Gurakan B. Relationship between thyroid hormone levels and transient tachypnea of the newborn in late-preterm, early-term, and term infants. J Matern Fetal Neonatal Med 2017; 32:1342-1346. [PMID: 29132242 DOI: 10.1080/14767058.2017.1405386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE We aimed to investigate the association between thyroid hormone levels and transient tachypnea of the newborn (TTN) among late-preterm, early-term, and term infants admitted to neonatal intensive care unit (NICU). MATERIALS AND METHOD In the current retrospective study, neonates admitted to the NICU due to TTN were assigned to the TTN group (n = 404). Healthy neonates who were followed up in the well-baby nursery comprised the control group (n = 7335). Infants were grouped by gestational age into late-preterm (34-366 weeks), early-term (37-386 weeks), and term subgroups (39-416 weeks). Serum levels of thyroid-stimulating hormone (TSH) and thyroxin (T4) were determined from venipuncture samples taken at least 48 hours after birth. The relationship between thyroid hormone levels and the need for NICU admission for TTN was compared between groups. RESULTS Compared to control infants, term neonates with TTN had significantly higher TSH levels, whereas late-preterm and early-term neonates with TTN had significantly lower T4 levels. Birth weight and mode of delivery had no effect on NICU admission for TTN. CONCLUSIONS Infants admitted to NICU due to TTN had significantly different thyroid hormone levels with differences depending on gestational age.
Collapse
Affiliation(s)
| | - Seçil Erçin
- b Neonatal Intensive Care Unit , American Hospital , Istanbul , Turkey
| | - Petek Kayıran
- a Department of Pediatrics , American Hospital , Istanbul , Turkey
| | - Tugba Gursoy
- c Neonatal Intensive Care Unit, Department of Pediatrics , Koc University School of Medicine , İstanbul , Turkey
| | - Berkan Gurakan
- a Department of Pediatrics , American Hospital , Istanbul , Turkey
| |
Collapse
|
30
|
Aktas ON, Gursoy T, Soysal E, Esencan E, Ercin S. Thyroid hormone levels in late preterm, early term and term infants: a study with healthy neonates revealing reference values and factors affecting thyroid hormones. J Pediatr Endocrinol Metab 2017; 30:1191-1196. [PMID: 28988227 DOI: 10.1515/jpem-2017-0215] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 05/28/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Thyroid function tests in neonates have been challenging to interpret because their levels are affected by several neonatal and delivery-related factors. The aim of the study was to evaluate reference values of thyroxine (T4) and thyrotropin (TSH) levels in different gestational age groups and to demonstrate the affect of perinatal factors on thyroid hormones. METHODS Medical records of 7616 neonates whose gestational age ranges between 34 and 42 weeks were analyzed retrospectively. Gender, mode of delivery, gestational age, postnatal age and birth weight were noted together with TSH and T4 levels. RESULTS Gestational age (r=0.14, p<0.001) and birth weight (r=0.12, p<0.001) had positive correlation with T4 levels, whereas they had no effect on TSH levels. Males had higher TSH and lower T4 levels (p=0.001 for both) compared with females. T4 levels of babies born via vaginal delivery were lower than the ones born via cesarean section (p=0.01). Multivariable analysis yielded gestational age as the only factor affecting T4 levels (p<0.001). T4 and TSH levels based on 2.5-97.5 percentile cutoffs according to gestational age were presented. CONCLUSIONS The thyroid hormone ranges given in this study can help pediatricians to interpret the thyroid hormone results with ease.
Collapse
|
31
|
Thyroid-stimulating hormone levels in newborns and early life exposure to endocrine-disrupting chemicals: analysis of three European mother-child cohorts. Pediatr Res 2017; 82:429-437. [PMID: 28288144 DOI: 10.1038/pr.2017.50] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 02/06/2017] [Indexed: 01/09/2023]
Abstract
BackgroundVarious studies have reported interactions between thyroid hormones and early life chemical exposure. Our objective was to analyze the associations between markers of endocrine-disrupting chemical exposure and thyroid function in newborns, determined through heel prick blood spots.MethodsThree European mother-child cohorts (FLEHSI-Belgium, HUMIS-Norway, and the PCB cohort-Slovakia. Total n=1,784) were pooled for the purpose of this study. Data on thyroid-stimulating hormone (TSH) were obtained from national neonatal screening registries, and samples of cord plasma and/or breast milk were collected to determine exposure to various chemicals. Multiple regression models were composed with exposure and cohort as fixed factors, and adjustments were made for a priori defined covariates.ResultsMedian TSH concentrations were 1, 1.10, and 2.76 mU/l for the Belgian, Norwegian, and Slovak cohorts, respectively. For polychlorinated biphenyl (PCB)-153 and dichlorodiphenyldichloroethylene (p,p'-DDE), children in the third exposure quartile had a 12-15% lower TSH at birth. Results remained unchanged after additional adjustment for birth weight and gestational weight gain. No effect on TSH was observed for the other compounds.ConclusionEarly life exposure to PCB-153 and p,p'-DDE impacts newborn TSH levels. Higher exposure levels were associated with 12-15% lower TSH levels.
Collapse
|
32
|
Valizadeh M, Nazeri P, Fazli F, Mohammadian F, Kalantari S, Kamali K, Osali H. Application of povidone-iodine at delivery significantly increases maternal urinary iodine but not neonatal thyrotropin in an area with iodine sufficiency. J Pediatr Endocrinol Metab 2017; 30:967-972. [PMID: 28763301 DOI: 10.1515/jpem-2017-0087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 07/03/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND The aim of the present study was to investigate the effect of povidone-iodine (PVP-I) application at delivery on maternal urinary iodine concentration (UIC) and neonatal thyrotropin concentration. METHODS In this cross-sectional study, urine samples were collected from each pregnant woman after admission to the hospital and before routine application of the PVP-I for delivery preparation and after delivery at time of screening for congenital hypothyroidism. A heel-prick blood sample was taken from all newborns. RESULTS A total of 394 pregnant women at time of delivery participated in this study. Median (interquartile range [IQR]) maternal UIC values were 120 (105-157) and 253 (126-470) μg/L before and after delivery, respectively (p<0.001). No significant correlations were observed between maternal UIC before and after delivery and neonatal thyrotropin levels. CONCLUSIONS Application of PVP-I significantly increased UIC in postpartum mothers; however, thyrotropin concentration in neonates, whose mothers had adequate UIC, was within the normal range.
Collapse
|
33
|
Janssen BG, Byun HM, Roels HA, Gyselaers W, Penders J, Baccarelli AA, Nawrot TS. Regulating role of fetal thyroid hormones on placental mitochondrial DNA methylation: epidemiological evidence from the ENVIR ONAGE birth cohort study. Clin Epigenetics 2017. [PMID: 28649287 PMCID: PMC5479026 DOI: 10.1186/s13148-017-0366-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Fetal development largely depends on thyroid hormone availability and proper placental function with an important role played by placental mitochondria. The biological mechanisms by which thyroid hormones exert their effects on mitochondrial function are not well understood. We investigated the role of fetal thyroid hormones on placental mitochondrial DNA (mtDNA) content and mtDNA methylation. We collected placental tissue and cord blood from 305 mother-child pairs that were enrolled between February 2010 and June 2014 in the ENVIRONAGE (ENVIRonmental influence ON early AGEing) birth cohort (province of Limburg, Belgium). Placental mtDNA content was determined by qPCR and placental mtDNA methylation by bisulfite-pyrosequencing in two regions, i.e., the D-loop control region and 12S ribosomal RNA (MT-RNR1). The levels of free thyroid hormones (FT3, FT4) and thyroid-stimulating hormone (TSH) were measured in cord blood. RESULTS Cord blood FT3 and FT4 were inversely associated with placental mtDNA methylation at the MT-RNR1 (p ≤ 0.01) and D-loop (p ≤ 0.05) regions, whereas a positive association was observed for both hormones with placental mtDNA content (p ≤ 0.04). Assuming causality, we estimated that MT-RNR1 and D-loop methylation mediated, respectively, 77% [indirect effect +14.61% (95% CI 2.64 to 27.98%, p = 0.01)] and 47% [indirect effect +8.60% (95% CI 1.23 to 16.50%, p = 0.02] of the positive association between FT3 and placental mtDNA content. Mediation models with FT4 gave similar results but the estimated effect proportions were smaller compared with those of FT3 (54% and 24%, respectively). CONCLUSIONS We showed that epigenetic modification at specific loci of the mitochondrial genome could intervene with the thyroid-dependent regulation of mitochondrial DNA copy numbers.
Collapse
Affiliation(s)
- Bram G Janssen
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Hyang-Min Byun
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE4 5PL UK
| | - Harry A Roels
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium.,Louvain Centre for Toxicology and Applied Pharmacology (LTAP), Université catholique de Louvain, Brussels, Belgium
| | - Wilfried Gyselaers
- Department of Obstetrics, East-Limburg Hospital, Genk, 3600 Belgium.,Biomedical Research Institute, Hasselt University, Diepenbeek, 3590 Belgium
| | - Joris Penders
- Biomedical Research Institute, Hasselt University, Diepenbeek, 3590 Belgium.,Laboratory of Clinical Biology, East-Limburg Hospital, Genk, 3600 Belgium
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032 USA
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium.,Department of Public Health & Primary Care, Occupational & Environmental Medicine, Leuven University, Leuven, Belgium
| |
Collapse
|
34
|
Janssen BG, Saenen ND, Roels HA, Madhloum N, Gyselaers W, Lefebvre W, Penders J, Vanpoucke C, Vrijens K, Nawrot TS. Fetal Thyroid Function, Birth Weight, and in Utero Exposure to Fine Particle Air Pollution: A Birth Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:699-705. [PMID: 27623605 PMCID: PMC5382000 DOI: 10.1289/ehp508] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 08/08/2016] [Accepted: 08/16/2016] [Indexed: 05/22/2023]
Abstract
BACKGROUND Thyroid hormones are critical for fetal development and growth. Whether prenatal exposure to fine particle air pollution (≤ 2.5 μm; PM2.5) affects fetal thyroid function and what the impact is on birth weight in normal healthy pregnancies have not been studied yet. OBJECTIVES We studied the impact of third-trimester PM2.5 exposure on fetal and maternal thyroid hormones and their mediating role on birth weight. METHODS We measured the levels of free thyroid hormones (FT3, FT4) and thyroid-stimulating hormone (TSH) in cord blood (n = 499) and maternal blood (n = 431) collected after delivery from mother-child pairs enrolled between February 2010 and June 2014 in the ENVIRONAGE birth cohort with catchment area in the province of Limburg, Belgium. RESULTS An interquartile range (IQR) increment (8.2 μg/m3) in third-trimester PM2.5 exposure was inversely associated with cord blood TSH levels (-11.6%; 95% CI: -21.8, -0.1) and the FT4/FT3 ratio (-62.7%; 95% CI: -91.6, -33.8). A 10th-90th percentile decrease in cord blood FT4 levels was associated with a 56 g decrease in mean birth weight (95% CI: -90, -23). Assuming causality, we estimated that cord blood FT4 mediated 21% (-19 g; 95% CI: -37, -1) of the estimated effect of an IQR increment in third-trimester PM2.5 exposure on birth weight. Third-trimester PM2.5 exposure was inversely but not significantly associated with maternal blood FT4 levels collected 1 day after delivery (-4.0%, 95% CI: -8.0, 0.2 for an IQR increment in third-trimester PM2.5). CONCLUSIONS In our study population of normal healthy pregnancies, third-trimester exposure to PM2.5 air pollution was associated with differences in fetal thyroid hormone levels that may contribute to reduced birth weight. Additional research is needed to confirm our findings in other populations and to evaluate potential consequences later in life.
Collapse
Affiliation(s)
- Bram G. Janssen
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Nelly D. Saenen
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Harry A. Roels
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
- Louvain Centre for Toxicology and Applied Pharmacology (LTAP), Université catholique de Louvain, Brussels, Belgium
| | - Narjes Madhloum
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Wilfried Gyselaers
- Biomedical Research Institute, Hasselt University, Hasselt, Belgium
- Department of Obstetrics, East-Limburg Hospital, Genk, Belgium
| | - Wouter Lefebvre
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Joris Penders
- Biomedical Research Institute, Hasselt University, Hasselt, Belgium
- Department of Clinical Biology, East-Limburg Hospital, Genk, Belgium
| | | | - Karen Vrijens
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Tim S. Nawrot
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
- Department of Public Health and Primary Care, Occupational and Environmental Medicine, Leuven University, Leuven, Belgium
- Address correspondence to T.S. Nawrot, Centre for Environmental Sciences, Hasselt University, Agoralaan gebouw D, 3590 Diepenbeek, Belgium. Telephone: 32-11-268382. E-mail:
| |
Collapse
|
35
|
Lee SY. Perinatal factors associated with neonatal thyroid-stimulating hormone in normal newborns. Ann Pediatr Endocrinol Metab 2016; 21:206-211. [PMID: 28164073 PMCID: PMC5290175 DOI: 10.6065/apem.2016.21.4.206] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 10/18/2016] [Accepted: 11/09/2016] [Indexed: 11/20/2022] Open
Abstract
PURPOSE This study was to evaluate the effect of neonatal, maternal, and delivery factors on neonatal thyroid-stimulating hormone (TSH) of healthy newborns. METHODS Medical records of 705 healthy infants born through normal vaginal delivery were reviewed. Neonatal TSH levels obtained by neonatal screening tests were analyzed in relation to perinatal factors and any associations with free thyroxine (FT4) and 17-α hydroxyprogesterone (17OHP) levels. RESULTS An inverse relationship was found between TSH and sampling time after birth. Twin babies and neonates born by vacuum-assisted delivery had higher TSH levels than controls. First babies had higher TSH levels than subsequent babies. Birth weight, gestational age, maternal age and duration from the rupture of the membrane to birth were not related to neonatal TSH. There were no significant differences in TSH level according to sex, Apgar scores, labor induction, the presence of maternal disease and maternal medications. There was a positive association between TSH and 17OHP level but not between TSH and FT4 level. Multiple linear regression analyses showed that sampling time, mode of delivery, birth order, and 17OHP level were significant factors affecting neonatal TSH level. CONCLUSION Neonatal TSH levels of healthy normal newborns are related with multiple factors. Acute stress during delivery may influence the neonatal TSH level in early neonatal period.
Collapse
Affiliation(s)
- Seong Yong Lee
- Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| |
Collapse
|
36
|
Howells FM, Donald KA, Roos A, Woods RP, Zar HJ, Narr KL, Stein DJ. Reduced glutamate in white matter of male neonates exposed to alcohol in utero: a (1)H-magnetic resonance spectroscopy study. Metab Brain Dis 2016; 31:1105-12. [PMID: 27311608 PMCID: PMC6465962 DOI: 10.1007/s11011-016-9850-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 05/30/2016] [Indexed: 10/21/2022]
Abstract
In utero exposure to alcohol leads to a spectrum of fetal alcohol related disorders (FASD). However, few studies used have used proton magnetic resonance spectroscopy ((1)H-MRS) to understand how neurochemical disturbances relate to the pathophysiology of FASD. Further, no studies to date have assessed brain metabolites in infants exposed to alcohol in utero. We hypothesize that neonates exposed to alcohol in utero will show decreased glutamatergic activity, pre-emptive of their clinical diagnosis or behavioural phenotype. Single voxel (1)H-MRS data, sampled in parietal white and gray matter, were acquired from 36 neonates exposed to alcohol in utero, and 31 control unexposed healthy neonates, in their 2nd-4th week of life. Metabolites relative to creatine with phosophocreatine and metabolites absolute concentrations using a water reference are reported. Male infants exposed to alcohol in utero were found to have reduced concentration of glutamate with glutamine (Glx) in their parietal white matter (PWM), compared to healthy male infants (p = 0.02). Further, male infants exposed to alcohol in utero had reduced concentration and ratio for glutamate (Glu) in their PWM (p = 0.02), compared to healthy male infants and female infants exposed to alcohol in utero. Female infants showed higher relative Glx and Glu ratios for parietal gray matter (PGM, p < 0.01), compared to male infants. We speculate that the decreased Glx and Glu concentrations in PWM are a result of delayed oligodendrocyte maturation, which may be a result of dysfunctional thyroid hormone activity in males exposed to alcohol in utero. Further study is required to elucidate the relationship between Glx and Glu, thyroid hormone activity, and oligodendrocyte maturation in infants exposure to alcohol in utero.
Collapse
Affiliation(s)
- F M Howells
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
| | - K A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa
| | - A Roos
- Medical Research Council Anxiety and Stress Disorders Unit, University of Stellenbosch, Stellenbosch, South Africa
| | - R P Woods
- Departments of Neurology and of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa
| | - K L Narr
- Departments of Neurology and of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - D J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
37
|
Liu R, Xu X, Zhang Y, Zheng X, Kim SS, Dietrich KN, Ho SM, Reponen T, Chen A, Huo X. Thyroid Hormone Status in Umbilical Cord Serum Is Positively Associated with Male Anogenital Distance. J Clin Endocrinol Metab 2016; 101:3378-85. [PMID: 27383112 PMCID: PMC5010576 DOI: 10.1210/jc.2015-3872] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 06/28/2016] [Indexed: 02/05/2023]
Abstract
CONTEXT In human adults and adolescents, thyroid function affects sex hormones and male reproductive functions. Little is known about the thyroid function effects on the gonadal development in human infants. OBJECTIVE The aim was to examine the association between thyroid hormones (THs) and sexually dimorphic genital development or fetal growth. DESIGN This is a birth cohort study. PARTICIPANTS A total of 616 mothers and newborns were analyzed from two local hospitals. MAIN OUTCOME MEASURES TSH, free T3 (FT3), and free T4 (FT4) levels in cord blood serum, anogenital distance (AGD), birth weight, birth length, birth body mass index, and head circumference in neonates. RESULTS Longer AGD in male newborns was observed with higher cord serum FT3 (β, 1.36 mm [95% confidence interval (CI), 0.58-2.13] for 1 pmol/L FT3), FT4 (β, 0.12 mm [95% CI, 0.00-0.25] for 1 pmol/L FT4), and TSH (β, 3.14 mm [95% CI, 0.65-5.63] for a 10-fold TSH increase), and with a lower FT4/FT3 ratio (β, -0.11 mm [95% CI, -0.20 to -0.02] for doubling FT4/FT3 ratio). The relationships between TSH, birth weight, and birth length were different by secondhand smoke exposure. Secondhand smoke exposure had an effect modification, with interaction P value .039 and .010, respectively. Secondhand smoke exposure also had an effect modification on the relation between FT4 and head circumference with interaction P value .020. CONCLUSIONS In the absence of overt thyroid dysfunction, THs are positively associated with AGD in male newborns. TH effects on body size and head circumference may be modified by maternal secondhand smoke exposure.
Collapse
Affiliation(s)
- Rongju Liu
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Yuling Zhang
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Xiangbin Zheng
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Stephani S Kim
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Kim N Dietrich
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Shuk-Mei Ho
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Tiina Reponen
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Aimin Chen
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| |
Collapse
|
38
|
Mehari A, Challa F, Gebreyesus G, Alemayehu D, Seifu D. Establishment of reference intervals of thyroid function tests from cord blood of neonates in two selected hospitals, Addis Ababa, Ethiopia. BMC Pediatr 2016; 16:118. [PMID: 27484127 PMCID: PMC4969665 DOI: 10.1186/s12887-016-0654-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 07/20/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Reference intervals are affected by different factors such as lifestyle, ethnicity, age/developmental stage, gender, nutrition and other environmental factors (Clin Biochem Rev: 29,2008). Therefore, it is obvious that it should be established for every population in different regions even within a country. Then the aim of this study is to establish population specific reference intervals of thyroid stimulating hormone, free thyroxine and free triidothyronine levels of cord blood. RESULTS One hundred twenty three cord blood samples collected from the umbilical cord of newborns were analyzed for thyroid stimulating hormone, free thyroxine and free triidothyronine values. The birth weights ranged between 2500 and 4700 g with mean (SD) value of 3241.46 (459.495) gram. Their gestational age ranged between 37 and 44 weeks with an average of 39.74 weeks. The 2.5(th) and 97.5(th) percentiles of values were found to be 3.48 mIU/L and 27.57 mIU/L for thyroid stimulating hormone, 0.89 ng/dl and 1.53 ng/dl for free thyroxine and 1.19 pg/ml and 2.51 pg/ml for free triidothyronine respectively. CONCLUSION In the present study the reference intervals of thyroid stimulating hormone, free thyroxine and free triidothyronine were established and based on the results obtained, were 3.48-27.56 mIU/L for thyroid stimulating hormone, 0.89-1.53 ng/dl for free thyroxine and 1.19-2.51 pg/ml for free triidothyronine. It has been concluded that the result can provide us with an important baseline to establish population specific reference intervals for our country using large scale studies.
Collapse
Affiliation(s)
- Aman Mehari
- Department of Medical Biochemistry and Molecular Biology, Biomedical Institute, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Feyssa Challa
- Clinical Chemistry Department, Directorate of TB & HIV research, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Goitom Gebreyesus
- Department of Pediatrics, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Dereje Alemayehu
- Department of Pediatrics, Gandhi Memorial Hospital, Addis Ababa, Ethiopia
| | - Daniel Seifu
- Department of Biochemistry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
39
|
Tunc-Ozcan E, Harper KM, Graf EN, Redei EE. Thyroxine administration prevents matrilineal intergenerational consequences of in utero ethanol exposure in rats. Horm Behav 2016; 82:1-10. [PMID: 27090562 PMCID: PMC4902747 DOI: 10.1016/j.yhbeh.2016.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 03/23/2016] [Accepted: 04/14/2016] [Indexed: 01/15/2023]
Abstract
The neurodevelopmental fetal alcohol spectrum disorder (FASD) is characterized by cognitive and behavioral deficits in the offspring. Conferring the deficits to the next generation would increase overall FASD disease burden and prevention of this transmission could be highly significant. Prior studies showed the reversal of these behavioral deficits by low dose thyroxine (T4) supplementation to the ethanol-consuming mothers. Here we aim to identify whether prenatal ethanol (PE) exposure impairs hippocampus-dependent learning and memory in the second-generation (F2) progeny, and whether T4 administration to the ethanol-consuming dam can prevent it. Sprague-Dawley (S) dams received control diets (ad libitum and nutritional control) or ethanol containing liquid diet with and without simultaneous T4 (0.3mg/L diet) administration. Their offspring (SS F1) were mated with naive Brown Norway (B) males and females generating the SB F2 and BS F2 progeny. Hippocampus-dependent contextual fear memory and hippocampal expression of the thyroid hormone-regulated type 3 deiodinase, (Dio3) and neurogranin (Nrgn) were assessed. SS F1 PE-exposed females and their SB F2 progeny exhibited fear memory deficits. T4 administration to the mothers of F1 females reversed these deficits. Although SS F1 PE-exposed males also experienced fear memory deficit, this was neither transmitted to their BS F2 offspring nor reversed by prenatal T4 treatment. Hippocampal Dio3 and Nrgn expression showed similar pattern of changes. Grandmaternal ethanol consumption during pregnancy affects fear memory of the matrilineal second-generation progeny. Low dose T4 supplementation prevents this process likely via altering allele-specific and total expression of Dio3 in the hippocampus.
Collapse
Affiliation(s)
- Elif Tunc-Ozcan
- The Asher Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States
| | - Kathryn M Harper
- The Asher Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States
| | - Evan N Graf
- The Asher Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States
| | - Eva E Redei
- The Asher Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States.
| |
Collapse
|
40
|
Keshavarzian E, Valipoor AA, Maracy MR. The incidence of congenital hypothyroidism and its determinants from 2012 to 2014 in Shadegan, Iran: a case-control study. Epidemiol Health 2016; 38:e2016021. [PMID: 27283138 PMCID: PMC4967912 DOI: 10.4178/epih.e2016021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 05/26/2016] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES: Congenital hypothyroidism (CH) is one of the major causes of preventable mental retardation in infants. The aim of this study was to determine the incidence of CH in Shadegan, Khuzestan Province, Iran from 2012 to 2014 and to identify the risk factors associated with CH. METHODS: A total of 203 cases were confirmed from 2012 to 2014 in Shadegan, with 66, 86, and 51 patients reported in 2012, 2013, and 2014, respectively. A total of 3,900, 3,991, and 4,050 live births occurred in 2012, 2013, and 2014, respectively. The controls (n=657) were selected using a random number table, and a case-control study was carried out to determine the risk factors for neonatal CH, including demographic, environmental, and medical factors. RESULTS: The incidence of CH was 17.0 per 1,000 live births in 2012, 21.5 per 1,000 live births in 2013, and 12.6 per 1,000 live births in 2014. This study showed that the likelihood of CH in children born to parents with a history of consanguineous marriage was 2.41 times greater than in children born to parents with no such history (odds ratio, 2.41; 95% confidence interval [CI], 1.65 to 3.53). This study also found that CH was 3.4 times more likely (95% CI, 2.29 to 5.20) in infants born in urban settings than in infants born in rural areas. CONCLUSIONS: The incidence of CH in Shadegan from 2012 to 2014 was approximately 17 times greater than the expected incidence in Iran. CH was associated with a history of consanguineous marriage and urbanization.
Collapse
Affiliation(s)
- Ehsan Keshavarzian
- Student Research Center, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Mohammad Reza Maracy
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
41
|
Can postpartum maternal urinary iodine be used to estimate iodine nutrition status of newborns? Br J Nutr 2016; 115:1226-31. [DOI: 10.1017/s0007114516000064] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractI deficiency can lead to detrimental effects, particularly in neonates and young infants. The aim of this study was to explore whether postpartum maternal urinary I can be used to estimate the I status of newborns. In this cross-sectional study conducted in Tehran, lactating mothers and newborns, within 3–5 d postpartum, were randomly selected. Urine samples were collected from each mother and newborn, and a heel-prick blood sample was obtained from all newborns as part of the routine national newborn screening programme. According to the WHO criteria, median urinary I concentration (UIC) <100 µg/l and frequency over 3 % of thyroid stimulating hormone (TSH) >5 mIU/l was considered as I insufficiency. A total of 147 postpartum women and neonates, aged 27·8 (sd5·3) years and 4·2 (sd0·6) d, respectively, completed this study. The median UIC was 68·0 (interquartile range (IQR) 39·4–133·5) and 212·5 (IQR 92·3–307·3) µg/l in postpartum mothers and newborns, respectively. The median neonatal TSH was 1·00 (IQR 0·50–1·70) mIU/l. There was no significant difference in the neonatal UIC and TSH of infants whose mothers had deficient and sufficient urinary I. In the multiple linear regression, neonatal UIC value was associated with maternal urinary I (P=0·048) and parity (P=0·039); a significant association was observed between neonatal TSH and infant sex (P=0·038) and birth weight (P=0·049). The findings of our study demonstrate that, despite postpartum mothers being mildly I deficient, I status of their infants was adequate as assessed by UIC and TSH values. It seems factors other than maternal urinary I may influence the I status in newborns.
Collapse
|
42
|
Trumpff C, Vandevijvere S, Moreno-Reyes R, Vanderpas J, Tafforeau J, Van Oyen H, De Schepper J. Neonatal thyroid-stimulating hormone level is influenced by neonatal, maternal, and pregnancy factors. Nutr Res 2015; 35:975-81. [DOI: 10.1016/j.nutres.2015.09.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 08/28/2015] [Accepted: 09/01/2015] [Indexed: 01/03/2023]
|
43
|
Lain SJ, Roberts CL, Wilcken B, Wiley V, Jack MM, Nassar N. Using record linkage to investigate perinatal factors and neonatal thyroid-stimulating hormone. J Paediatr Child Health 2015; 51:620-5. [PMID: 25425135 DOI: 10.1111/jpc.12783] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/21/2014] [Indexed: 11/30/2022]
Abstract
AIM Studies examining the relationship between maternal and infant thyroid parameters have shown conflicting results. Record linkage provides an opportunity to examine the association between maternal and infant thyroid-stimulating hormone (TSH) levels. Our aim was to demonstrate the feasibility of record linkage of newborn screening (NBS), laboratory and birth databases for research by investigating the association between maternal and newborn TSH levels. METHODS The records of 2802 women with first trimester serum TSH concentrations were linked with population-based birth data and NBS data containing infant TSH levels. Association between moderately high neonatal TSH levels (>5 mIU/L) and maternal and infant characteristics was evaluated. The correlation and association between maternal and infant TSH levels were assessed using Pearson's correlation coefficient and multivariable linear regression, respectively. RESULTS Of maternal and birth records, 99.3% linked with an NBS record. Mother's country of birth, gestational age (>41 weeks) and lower birthweight were associated with neonatal TSH levels >5 mIU/L. Neonatal and maternal first trimester TSH levels were not correlated, although statistically significant (r = 0.05, P = 0.008). The association between neonatal TSH and maternal TSH, after adjusting for maternal age, gestational age and age at NBS testing, was also small (b = 0.039, P = 0.009). CONCLUSIONS Record linkage is a feasible and cost-efficient way to investigate the association between maternal factors and neonatal hormone levels. First trimester maternal thyroid levels are not correlated with neonatal TSH levels. This method of outcome assessment can be used for future research examining long-term outcomes for infants with different NBS results.
Collapse
Affiliation(s)
- Samantha J Lain
- Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Christine L Roberts
- Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Bridget Wilcken
- Disciplines of Genetic Medicine and Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia.,NSW Newborn Screening Programme, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Veronica Wiley
- Disciplines of Genetic Medicine and Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia.,NSW Newborn Screening Programme, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Michelle M Jack
- Department of Paediatric Endocrinology, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Natasha Nassar
- Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
44
|
Association between Several Persistent Organic Pollutants and Thyroid Hormone Levels in Cord Blood Serum and Bloodspot of the Newborn Infants of Korea. PLoS One 2015; 10:e0125213. [PMID: 25965908 PMCID: PMC4429016 DOI: 10.1371/journal.pone.0125213] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 03/23/2015] [Indexed: 11/19/2022] Open
Abstract
Current knowledge on adverse endocrine disruption effects of persistent organic pollutants (POPs) among newborn infants is limited and often controversial. To investigate the associations between prenatal exposure to major POPs and thyroid hormone levels among newborn infants, both cord serum or maternal serum concentrations of polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), and organochlorine pesticides (OCPs) were compared with five thyroid hormones in cord serum of newborn infants as well as TSH in bloodspot collected at 2 day after birth (n=104). Since cord serum thyroid hormones could be affected by those of mothers, thyroid hormone concentrations of the matching mothers at delivery were adjusted. In cord serum, BDE-47, -99, and Σchlordane (CHD) showed significant positive associations with cord or bloodspot TSH. At the same time, p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) and hexachlorbenzene (HCB) showed negative associations with total T3 and total T4 in cord serum, respectively. Maternal exposure to β-hexachlorhexane (β-HCH), ΣCHD, ΣDDT, or p,p'-DDE were also associated with neonatal thyroid hormones. Although the sample size is small and the thyroid hormone levels of the subjects were within the reference range, our observation supports thyroid disrupting potential of several POPs among newborn infants, at the levels occurring in the general population. Considering the importance of thyroid hormones during gestation and early life stages, health implication of thyroid hormone effects by low level POPs exposure deserves further follow up investigations.
Collapse
|
45
|
Gopalakrishnan V, Joshi K, Phadke S, Dabadghao P, Agarwal M, Das V, Jain S, Gambhir S, Gupta B, Pandey A, Kapoor D, Kumar M, Bhatia V. Newborn screening for congenital hypothyroidism, galactosemia and biotinidase deficiency in Uttar Pradesh, India. Indian Pediatr 2015; 51:701-5. [PMID: 25228601 DOI: 10.1007/s13312-014-0485-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess feasibility and recall rates for newborn screening for congenital hypothyroidism, galactosemia and biotinidase deficiency in a predominantly rural and inner city population in and around the City of Lucknow in Uttar Pradesh, India. DESIGN Prospective observational study. SETTING Two tertiary-care and 5 district hospitals in and around Lucknow. PARTICIPANTS All babies born in above hospitals during the study period. METHODS Heel prick samples were collected after 24 hours of life. Dried blood spot TSH, total galactose and biotinidase were assayed by immunofluorometry. Age related cut-offs were applied for recall for TSH. For galactosemia and biotinidase deficiency, manufacturer-suggested recall cut-offs used initially were modified after analysis of initial data. MAIN OUTCOME MEASURE Recall rate for hypothyroidism, galactosemia and biotinidase deficiency. RESULTS Screening was carried out for 13426 newborns, 73% of all deliveries. Eighty-five percent of those recalled for confirmatory sampling responded. Using fixed TSH cut off of 20 mIU/L yielded high recall rate of 1.39%, which decreased to 0.84% with use of age-related cut-offs. Mean TSH was higher in males, and in low birth weight and vaginally delivered babies. Eleven babies had congenital hypothyroidism. Recall rates with modified cut-offs for galactosemia and biotinidase deficiency were 0.32% and 0.16%, respectively. CONCLUSIONS An outreach program for newborn screening can be successfully carried out in similar socio-cultural settings in India. For hypothyroidism, the high recall rate due to early discharge was addressed by age-related cut-offs.
Collapse
Affiliation(s)
- Vignesh Gopalakrishnan
- Departments of Endocrinology, *Medical Genetics, $Nuclear Medicine and ^Obstetrics and Gynecology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS); Departments of #Obstetrics and Gynecology and ‡Pediatrics, King George's Medical University (KGMU); and †Suvidha Diagnostics, Lucknow, Uttar Pradesh, India. Correspondence to: Dr V Bhatia, Department of Endocrinology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Romano ME, Webster GM, Vuong AM, Thomas Zoeller R, Chen A, Hoofnagle AN, Calafat AM, Karagas MR, Yolton K, Lanphear BP, Braun JM. Gestational urinary bisphenol A and maternal and newborn thyroid hormone concentrations: the HOME Study. ENVIRONMENTAL RESEARCH 2015; 138:453-60. [PMID: 25794847 PMCID: PMC4403004 DOI: 10.1016/j.envres.2015.03.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 02/14/2015] [Accepted: 03/08/2015] [Indexed: 05/20/2023]
Abstract
Bisphenol A (BPA), an endocrine disruptor used in consumer products, may perturb thyroid function. Prenatal BPA exposure may have sex-specific effects on thyroid hormones (THs). Our objectives were to investigate whether maternal urinary BPA concentrations during pregnancy were associated with THs in maternal or cord serum, and whether these associations differed by newborn sex or maternal iodine status. We measured urinary BPA concentrations at 16 and 26 weeks gestation among pregnant women in the HOME Study (2003-2006, Cincinnati, Ohio). Thyroid stimulating hormone (TSH) and free and total thyroxine (T4) and triiodothyronine (T3) were measured in maternal serum at 16 weeks (n=181) and cord serum at delivery (n=249). Associations between BPA concentrations and maternal or cord serum TH levels were estimated by multivariable linear regression. Mean maternal urinary BPA was not associated with cord THs in all newborns, but a 10-fold increase in mean BPA was associated with lower cord TSH in girls (percent change=-36.0%; 95% confidence interval (CI): -58.4, -1.7%), but not boys (7.8%; 95% CI: -28.5, 62.7%; p-for-effect modification=0.09). We observed no significant associations between 16-week BPA and THs in maternal or cord serum, but 26-week maternal BPA was inversely associated with TSH in girls (-42.9%; 95% CI: -59.9, -18.5%), but not boys (7.6%; 95% CI: -17.3, 40.2%; p-for-effect modification=0.005) at birth. The inverse BPA-TSH relation among girls was stronger, but less precise, among iodine deficient versus sufficient mothers. Prenatal BPA exposure may reduce TSH among newborn girls, particularly when exposure occurs later in gestation.
Collapse
Affiliation(s)
- Megan E Romano
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
| | - Glenys M Webster
- Child and Family Research Institute, BC Children's and Women's Hospital and Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Ann M Vuong
- Division of Epidemiology and Biostatistics, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - R Thomas Zoeller
- Department of Biology, University of Massachusetts, Amherst, MA, USA
| | - Aimin Chen
- Division of Epidemiology and Biostatistics, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Margaret R Karagas
- Children's Environmental Health and Disease Prevention Research Center and Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Kimberly Yolton
- Division of General and Community Pediatrics, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Bruce P Lanphear
- Child and Family Research Institute, BC Children's and Women's Hospital and Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Joseph M Braun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| |
Collapse
|
47
|
Kurtoğlu S, Köroğlu Ş, Baştuğ O, Daar G, Yıkılmaz A, Elmalı F. The comparison of thyroxine versus thyroxine plus oral iodine in the treatment of congenital hypothyroidism due to iodine deficiency. Horm Res Paediatr 2015; 81:409-15. [PMID: 24776962 DOI: 10.1159/000358878] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 01/21/2014] [Indexed: 11/19/2022] Open
Abstract
AIM Iodine deficiency is one of the most important causes of congenital hypothyroidism. In addition to thyroid hormone replacement, iodine supplementation is also given to newborns with congenital hypothyroidism due to iodine deficiency. We aimed to determine whether it is beneficial to administer iodine supplementation in addition to the L-thyroxine (L-T4) treatment of newborns with congenital hypothyroidism due to iodine deficiency. MATERIALS AND METHODS Of 51 newborns, 26 who were diagnosed with congenital hypothyroidism due to iodine deficiency were treated with L-T4. The remaining 25 cases were given L-T4 plus 100 μg/day of oral iodine. Free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone (TSH), thyroglobulin (TG), thyroid volume, urine iodine and breast milk iodine levels were measured in the first and third months of treatment, and the data were compared between the two groups. RESULTS First- and third-month values of fT3, fT4, TSH, TG and thyroid volume for both groups were statistically similar. There was no significant difference between the two groups in respect to falling levels of fT3 and TSH, the rate of increase of fT4 levels or the shrinkage rate of thyroid volume. CONCLUSION In this study, the addition of oral iodine to L-T4 treatment provided no benefit compared to treatment with L-T4 alone.
Collapse
Affiliation(s)
- Selim Kurtoğlu
- Department of Neonatology and Pediatric Endocrinology, Erciyes University Medical Faculty, Kayseri, Turkey
| | | | | | | | | | | |
Collapse
|
48
|
de Cock M, de Boer MR, Lamoree M, Legler J, van de Bor M. Prenatal exposure to endocrine disrupting chemicals in relation to thyroid hormone levels in infants - a Dutch prospective cohort study. Environ Health 2014; 13:106. [PMID: 25495114 PMCID: PMC4293007 DOI: 10.1186/1476-069x-13-106] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 11/26/2014] [Indexed: 05/23/2023]
Abstract
BACKGROUND Endocrine disrupting chemicals (EDCs) present in the environment may disrupt thyroid hormones, which in early life are essential for brain development. Observational studies regarding this topic are still limited, however as the presence of chemicals in the environment is ubiquitous, further research is warranted. The objective of the current study was to assess the association between exposure markers of various EDCs and thyroxine (T4) levels in newborns in a mother-child cohort in the Netherlands. METHODS Exposure to dichlorodiphenyldichloroethylene (DDE), three di-2-ethylhexyl phthalate (DEHP) metabolites, hexachlorobenzene (HCB), polychlorinated biphenyl (PCB)-153, perfluorooctanesulfonic acid (PFOS), and perfluorooctanoic acid (PFOA) was determined in cord plasma or breast milk, and information on T4 levels in heel prick blood spots was obtained through the neonatal screening programme in the Netherlands. Linear regression models were composed to determine associations between each of the compounds and T4, which were stratified for gender and adjusted for a priori defined covariates. RESULTS Mean T4 level was 86.9 nmol/L (n = 83). Girls in the highest quartile of DDE and PFOA exposure showed an increased T4 level compared to the lowest quartile with both crude and fully adjusted models (DDE > 107.50 ng/L, +24.8 nmol/L, 95% CI 0.79, 48.75; PFOA > 1200 ng/L, +38.6 nmol/L, 95% CI 13.34, 63.83). In boys a lower T4 level was seen in the second quartile of exposure for both PFOS and PFOA, however after fully adjusting the models these associations were attenuated. No effects were observed for the other compounds. CONCLUSION DDE and perfluorinated alkyl acids may be associated with T4 in a sex-specific manner. These results should however be interpreted with caution, due to the relatively small study population. More research is warranted, as studies on the role of environmental contaminants in this area are still limited.
Collapse
Affiliation(s)
- Marijke de Cock
- />Faculty of Earth and Life Sciences, VU University, Section Health and Life Sciences, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Michiel R de Boer
- />Faculty of Earth and Life Sciences, VU University, Section Health and Life Sciences, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Marja Lamoree
- />Faculty of Earth and Life Sciences, Institute for Environmental Studies, VU University, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Juliette Legler
- />Faculty of Earth and Life Sciences, Institute for Environmental Studies, VU University, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Margot van de Bor
- />Faculty of Earth and Life Sciences, VU University, Section Health and Life Sciences, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| |
Collapse
|
49
|
Ryckman KK, Spracklen CN, Dagle JM, Murray JC. Maternal factors and complications of preterm birth associated with neonatal thyroid stimulating hormone. J Pediatr Endocrinol Metab 2014; 27:929-38. [PMID: 24854527 PMCID: PMC4260397 DOI: 10.1515/jpem-2013-0366] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 04/22/2014] [Indexed: 11/15/2022]
Abstract
Thyroid hormones are important regulators of fetal neurodevelopment. Among preterm infants, thyroid stimulating hormone (TSH) is highly variable. Understanding this variability will further improvements in screening for thyroid disorders in preterm infants. We examined 61 maternal and infant clinical and demographic factors for associations with neonatal TSH levels in 698 preterm neonates. TSH was measured as part of routine State-mandated newborn screening in Iowa. Of the maternal characteristics, nulliparous women (p=8×10-4), women with preeclampsia (p=2×10-3), and those with induced labor (p=3×10-3) had infants with higher TSH levels. TSH levels at the time of newborn screening were associated with respiratory distress syndrome (RDS) (p<0.0001) and sepsis (p=3×10-3). We replicated findings between parity and preeclampsia previously observed in primarily term infants. We also observed strong relationships between neonatal TSH and complications of prematurity including RDS and sepsis, which have implications for future studies examining this relationship both prenatally and longitudinally after birth.
Collapse
Affiliation(s)
- Kelli K Ryckman
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA
- Corresponding Author: Kelli K Ryckman, PhD, Assistant Professor, Department of Epidemiology, College of Public Health, University of Iowa, 105 River St, S414 CPHB, Iowa City, IA 52242, Telephone: 319-384-1546,
| | - Cassandra N Spracklen
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - John M Dagle
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Jeffrey C Murray
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| |
Collapse
|
50
|
Velasco I, Martín J, Gallego M, Gutiérrez-Repiso C, Santiago P, López-Siguero JP, Mesa EG, Peral JH, Pérez V, García-Fuentes E, Soriguer F. Maternal-fetal thyroid function at the time of birth and its relation with iodine intake. Thyroid 2013; 23:1619-26. [PMID: 23763592 DOI: 10.1089/thy.2013.0035] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The effects of moderate variations in dietary iodine intake on maternal and fetal thyroid function are poorly understood. Recent studies question the usefulness of neonatal screening of congenital hypothyroidism as a tool for monitoring iodine deficiency. We proposed to test the hypothesis of an association between iodine intake during the last trimester of pregnancy and fetal thyroid function at the time of birth. METHODS The study was undertaken at term in 233 healthy pregnant women (29.7±5.6 years) and in their newborn. Inclusion of women in the study was done within the 24 hours before delivery. RESULTS The median maternal urinary iodine concentration was 126.5 μg/L. The maternal free triiodothyronine (FT3), although not thyrotropin (TSH) and free thyroxine (FT4), correlated significantly with the urinary iodine concentration (r=0.17, p=0.013). The cord blood TSH, FT4, and FT3 correlated positively with the maternal urinary iodine concentration at the time of delivery (r=0.24, p=0.001; r=0.16, p=0.032; and r=0.24, p=0.003, respectively). The cord blood and heel blood TSH correlated positively with the amniotic fluid iodine concentration (r=0.21, p=0.015 and r=0.15, p=0.036). The cord blood TSH correlated positively with the cord blood FT4 (r=0.21, p=0.022) and FT3 (r=0.32, p=0.017). The maternal TSH correlated significantly with the cord blood TSH (r=0.22, p=0.014) and with the heel blood TSH (r=0.13, p=0.050). CONCLUSIONS The results of this study show the presence of a positive association of TSH-FT4 at the time of delivery, which may be modulated by the amount of iodine consumed by the mother during pregnancy.
Collapse
Affiliation(s)
- Inés Velasco
- 1 Gynecology & Obstetrics Service, Riotinto Hospital, Huelva, Spain
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|