Maternal hypothyroxinemia: psychoneurological deficits of progeny

Maternal thyroid function was evaluated clinically, by reproductive history, and by serial measurements of serum butanol-extractable iodine (thyroxine-like iodine), two before and two after 24 gestational weeks during 1,349 pregnancies. Three percent of the women were hypothyroxinemic. Developmental, intellectual, and motor abilities of progeny born to (Group I) 210 euthyroxinemic, (Group II) 15 hypothyroxinemic given adequate thyroid replacement therapy, and (Group III) 21 inadequately treated hypothyroxinemic women were compared. The groups of mothers exhibited no significant differences in intelligence, years of education, or chronological age. Mean developmental and intellectual scores at eight months, four and seven years of Group II progeny evidenced remarkably consistent similarity to scores of siblings and controls. At each age, mean developmental and intellectual scores were lower for Group III progeny, and motor scores of the latter were lowest. Some progeny of Group II mothers, treated only after 12 or 29 weeks, failed the ball catch and line walk tests; some had strabismus and other ocular disturbances. Could these deficits have originated with maternal hypothyroxinemia during first semester weeks before the thyroid-pituitary axis matures? Now in 1990-1991, early findings fit into the modern concepts of significant maternal gestational transfer of thyroxine to the fetus. The authors encourage prenatal and/or early gestational screening for maternal hypothyroxinemia and urge prescription of adequate thyroid replacement therapy for hypothyroxinemic women.

This article has been cited by other articles:

				C. Dosiou, G. D Sanders, S. S Araki, and L. M Crapo Screening pregnant women for autoimmune thyroid disease: a cost-effectiveness analysis. Eur. J. Endocrinol., June 1, 2008; 158(6): 841 - 851. [Abstract] [Full Text] [PDF]

				Subsection Reports J. Clin. Endocrinol. Metab., August 1, 2007; 92(8_suppl): s8 - s47. [Full Text] [PDF]

				M. Abalovich, N. Amino, L. A. Barbour, R. H. Cobin, L. J. De Groot, D. Glinoer, S. J. Mandel, and A. Stagnaro-Green Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society Clinical Practice Guideline J. Clin. Endocrinol. Metab., August 1, 2007; 92(8_suppl): s1 - s47. [Abstract] [Full Text] [PDF]

				A. F. Muller, H. A. Drexhage, and A. Berghout Postpartum Thyroiditis and Autoimmune Thyroiditis in Women of Childbearing Age: Recent Insights and Consequences for Antenatal and Postnatal Care Endocr. Rev., October 1, 2001; 22(5): 605 - 630. [Abstract] [Full Text] [PDF]

				R. C. Smallridge and P. W. Ladenson Hypothyroidism in Pregnancy: Consequences to Neonatal Health J. Clin. Endocrinol. Metab., June 1, 2001; 86(6): 2349 - 2353. [Full Text] [PDF]

				G. Morreale de Escobar, M. Jesús Obregón, and F. Escobar del Rey Is Neuropsychological Development Related to Maternal Hypothyroidism or to Maternal Hypothyroxinemia? J. Clin. Endocrinol. Metab., November 1, 2000; 85(11): 3975 - 3987. [Abstract] [Full Text]

				R. D. Utiger Maternal Hypothyroidism and Fetal Development N. Engl. J. Med., August 19, 1999; 341(8): 601 - 602. [Full Text]

				D. Glinoer The Regulation of Thyroid Function in Pregnancy: Pathways of Endocrine Adaptation from Physiology to Pathology Endocr. Rev., June 1, 1997; 18(3): 404 - 433. [Abstract] [Full Text]

				G. N. Burrow, D. A. Fisher, and P. R. Larsen Maternal and Fetal Thyroid Function N. Engl. J. Med., October 20, 1994; 331(16): 1072 - 1078. [Full Text]