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Controlled antenatal thyroid screening II: effect of treating maternal sub-optimal thyroid function on child cognition

Hales, Charlotte ORCID:, Taylor, Peter N. ORCID:, Channon, Sue ORCID:, Paradice, Ruth, McEwan, Kirsten, Zhang, Lei ORCID:, Gyedu, Michael, Bakhsh, Ameen, Okosieme, Onyebuchi, Muller, Ilaria ORCID:, Draman, Mohd S., Gregory, John W. ORCID:, Dayan, Colin ORCID:, Lazarus, John H., Rees, D. Aled ORCID: and Ludgate, Marian 2018. Controlled antenatal thyroid screening II: effect of treating maternal sub-optimal thyroid function on child cognition. Journal of Clinical Endocrinology and Metabolism 103 (4) , pp. 1583-1591. 10.1210/jc.2017-02378

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Context & Objective The Controlled Antenatal Thyroid Screening (CATS) study investigated treatment for suboptimal gestational thyroid function (SGTF) on childhood cognition and found no difference in IQ at 3 years between children of treated and untreated SGTF mothers. We have measured IQ in the same children at age 9.5-years and included children from normal-GTF mothers. Design, Setting & Participants One examiner, blinded to participant group, assessed children’s IQ (WISC-IV), long-term memory and motor function (NEPSY-II) from children of 119 treated and 98 untreated SGTF mothers plus children of 232 mothers with normal-GTF. Logistic regression explored the odds and percentages of IQ<85 in the groups. Results There was no difference in IQ<85 between children of mothers with normal-GTF and combined SGTF i.e. treated and untreated (fully adjusted OR=1.15 (95% CI 0.52, 2.51) p=0.731). Furthermore, there was no significant effect of treatment (untreated OR=1.33 (95% CI 0.53, 3.34), treated OR=0.75 (95% CI 0.27, 2.06) p=0.576). IQ< 85 was 6.03% in normal-GTF, 7.56% in treated and 11.22% in untreated groups. Analyses accounting for treated-SGTF women with FT4 >97.5th centile of the entire CATS-I cohort revealed no significant effect on child’s IQ<85 in CATS-II. IQ at age 3 predicted IQ at age 9.5 (p<0.0001) and accounted for 45% of the variation. Conclusions Maternal thyroxine during pregnancy did not improve child cognition at age 9.5 years. Our findings confirmed CATS-I and suggest that the lack of treatment effect may be due to the similar proportion of IQ<85 in children of women with normal-GTF and SGTF.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Centre for Trials Research (CNTRR)
Neuroscience and Mental Health Research Institute (NMHRI)
Publisher: Oxford University Press
ISSN: 0021-972X
Date of First Compliant Deposit: 12 February 2018
Date of Acceptance: 10 January 2018
Last Modified: 12 Jul 2024 19:57

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