Maternal thyroid disorder in pregnancy and risk... - Thyroid UK

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Maternal thyroid disorder in pregnancy and risk of cerebral palsy in the child: a population-based cohort study

helvella profile image
helvellaAdministrator
14 Replies

It is difficult to know quite how much of a finding this is. I suspect we in the UK might question the number of mothers found to have thyroid disorders. (Certainly we see quite a number of posts where what could be regarded as the results of a thyroid disorder are actually dismissed or ignored.)

The simple fact that the introductory paragraph puts forward the suggestion of cerebral palsy risk being raised by prenatal thyroid hormone disturbances is significant.

Certainly seems to deserve more research - as suggested.

BMC Pediatr. 2018 May 31;18(1):181. doi: 10.1186/s12887-018-1152-5.

Maternal thyroid disorder in pregnancy and risk of cerebral palsy in the child: a population-based cohort study.

Petersen TG1, Andersen AN2, Uldall P3, Paneth N4, Feldt-Rasmussen U5, Tollånes MC6, Strandberg-Larsen K2.

Author information

1 Section of Social Medicine, Department of Public Health, University of Copenhagen, Gothersgade 160, 1123, Copenhagen, Denmark. tagp@sund.ku.dk.

2 Section of Social Medicine, Department of Public Health, University of Copenhagen, Gothersgade 160, 1123, Copenhagen, Denmark.

3 Pediatric Department at Rigshospitalet, Juliane Maries Vej 8, 2100, Copenhagen, Denmark.

4 Department of Epidemiology & Biostatistics and Department of Pediatrics and Human Development, Michigan State University, 909 Fee Road, East Lansing, MI, 48824, USA.

5 Department of Medical Endocrinology at Rigshospitalet, Ole Maaloees Vej 26, 2200, Copenhagen, Denmark.

6 Domain for Mental and Physical Health at Norwegian Institute of Public Health, Kalfarveien 31, 5020, Bergen, Norway.

Abstract

BACKGROUND:

Cerebral palsy is the most frequent motor disability in childhood, but little is known about its etiology. It has been suggested that cerebral palsy risk may be increased by prenatal thyroid hormone disturbances. The objective of this study was to investigate whether maternal thyroid disorder is associated with increased risk of cerebral palsy.

METHODS:

A population-based cohort study using two study populations. 1) 1,270,079 children born in Denmark 1979-2007 identified in nationwide registers, and 2) 192,918 children born 1996-2009 recruited into the Danish National Birth Cohort and The Norwegian Mother and Child Cohort study, combined in the MOthers and BAbies in Norway and Denmark (MOBAND) collaboration cohort. Register-based and self-reported information on maternal thyroid disorder was studied in relation to risk of cerebral palsy and its unilateral and bilateral spastic subtypes using multiple logistic regression. Children were followed from the age of 1 year to the age of 6 years, and cerebral palsy was identified in nationwide registers with verified diagnoses.

RESULTS:

In register data, hypothyroidism was recognized in 12,929 (1.0%), hyperthyroidism in 9943 (0.8%), and unclassifiable thyroid disorder in 753 (< 0.1%) of the mothers. The odds ratio for an association between maternal thyroid disorder and bilateral spastic cerebral palsy was 1.0 (95% CI: 0.7-1.5). Maternal thyroid disorder identified during pregnancy was associated with elevated risk of unilateral spastic cerebral palsy (odds ratio 3.1 (95% CI: 1.2-8.4)). In MOBAND, 3042 (1.6%) of the mothers reported a thyroid disorder in pregnancy, which was not associated with cerebral palsy overall (odds ratio 1.2 (95% CI: 0.6-2.4)).

CONCLUSIONS:

Maternal thyroid disorder overall was not related to bilateral spastic cerebral palsy, but maternal thyroid disorder identified in pregnancy was associated with increased risk of unilateral spastic cerebral palsy. These findings should be replicated in studies making use of maternal blood samples.

KEYWORDS:

Cerebral palsy; Maternal thyroid disorder; Pregnancy; Prenatal exposure; Register-based cohort; The Danish National Birth Cohort; The Norwegian mother and child cohort study

PMID: 29855286

DOI: 10.1186/s12887-018-1152-5

ncbi.nlm.nih.gov/pubmed/298...

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helvella
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14 Replies
ShinyB profile image
ShinyB

Perfect timing re my brother, thank you!

helvella profile image
helvellaAdministrator in reply toShinyB

Have to admit, I hesitated to post this originally. Read your post, and decided it was appropriate.

ShinyB profile image
ShinyB in reply tohelvella

You honestly could have knocked me down with a feather when I googled CP & Hypothyroidism! I so nearly didn't, as it just seemed unlikely that it could be related. And lo and behold....

helvella profile image
helvellaAdministrator in reply toShinyB

If you have not already searched PubMed, have a look at the search results here:

ncbi.nlm.nih.gov/pubmed/?te...

(Only 63 papers - but that is quite a bit to read.)

ShinyB profile image
ShinyB in reply tohelvella

This is the first brief reference I found that alerted me to a connection: originsofcerebralpalsy.com/...

Yours are much better ammo for seeing the doc. Thanks so much! :D

ShinyB profile image
ShinyB in reply toShinyB

helvella With your skill in finding relevant research, I'm just wondering whether you have ever come across anything linking thyroid function and ectopic pregnancy? I've tried a few times to find anything but although there are lots of mentions of miscarriages & thyroid function, I've not come across anything about EP.

helvella profile image
helvellaAdministrator in reply toShinyB

I have only done a quick search on PubMed and got 75 papers listed. Some might be entirely irrelevant, but there appear to be some relevant ones there:

ncbi.nlm.nih.gov/pubmed/?te...

ShinyB profile image
ShinyB in reply tohelvella

Oh thank you! I was just using google, I hadn't thought to search within PubMed. Fab :)

helvella profile image
helvellaAdministrator in reply toShinyB

It does cut out the repetition, clickbait, etc. so prevalent on the internet. :-)

Therefore focuses on the possibly relevant rather than the "we want you to click here", random word hits and Google's algorithms. It is also amazingly good at taking a single word in you search terms and expanding it to cover different words - for example, type in hypothyroid and it will include hypothyroidism and myxedema and myxoedema.

Some of the links might refer to ectopic thyroid - for example, thyroid tissue in the tongue rather than its usual location.

ShinyB profile image
ShinyB in reply tohelvella

I feel so much better armed now with this revelation! Very grateful :)

Yes, with Dr Google I'd only found copious references to ectopic thyroid.

helvella profile image
helvellaAdministrator in reply toShinyB

Over 30 years after the first reference in your link, and we appear hardly any further forward. :-(

Perhaps the evidence is a bit better, but even the latest paper hardly makes an unassailable case and absolute proof.

ShinyB profile image
ShinyB in reply tohelvella

There was a neme on facebook recently, can't find it now or remember the wording - basically saying that once knowledge becomes accepted, after being resisted for decades, doctors say, "That's what we've always thought."

Pfft.

Marz profile image
Marz

Along with being Hypo come the vitamin deficiencies - especially B12 - which can also impact the wellbeing of the foetus. VitD too ...

Then of course the added problem of medics not testing correctly or understanding the results - what a minefield ....

Mikka profile image
Mikka

Thank you for that post.

I've long believed this to be the case although for me and my son it would not show up in statistics as no doctor believed I was hypothyroid during my pregnancies despite really obvious signs.

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