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Citation
Tags
HERO ID
19231
Reference Type
Journal Article
Subtype
Review
Title
Is neuropsychological development related to maternal hypothyroidism or to maternal hypothyroxinemia?
Author(s)
Morreale de Escobar, G; Obregon, MJ; Escobar del Ray, F
Year
2000
Is Peer Reviewed?
Yes
Journal
Journal of Clinical Endocrinology and Metabolism
ISSN:
0021-972X
EISSN:
1945-7197
Volume
85
Issue
11
Page Numbers
3975-3987
Language
English
PMID
11095417
DOI
10.1210/jc.85.11.3975
Abstract
Several recent publications have drawn attention to the role of the thyroid hormone status of the mother on the future neuropsychological development of the child. The screening of pregnant women for clinical or subclinical hypothyroidism based on second trimester elevated maternal TSH values has been proposed. Here, we have summarized present epidemiological and experimental evidence strongly suggesting that conditions resulting in first trimester hypothyroxinemia (a low for gestational age circulating maternal free T4, whether or not TSH is increased) pose an increased risk for poor neuropsychological development of the fetus. This would be a consequence of decreased availability of maternal T4 to the developing brain, its only source of thyroid hormone during the first trimester; T4 is the required substrate for the ontogenically regulated generation of T3 in the amounts needed for optimal development in different brain structures, both temporally and spatially. Normal maternal T3 concentrations do not seem to prevent the potential damage of a low supply of T4, although they might prevent an increase in circulating TSH and detection of the hypothyroxinemia if only TSH is measured. Hypothyroxinemia seems to be much more frequent in pregnant women than either clinical or subclinical hypothyroidism and autoimmune thyroid disease, especially in regions where the iodine intake of the pregnant woman is inadequate to meet her increased needs for T4. It is proposed that the screening of pregnant women for thyroid disorders should include the determination of free T4 as soon as possible during the first trimester as a major test, because hypothyroxinemia has been related to poor developmental outcome, irrespective of the presence of high titers of thyroid autoantibodies or elevated serum TSH. The frequency with which this may occur is probably 150 times or more that of congenital hypothyroidism, for which successful screening programs have been instituted in many countries.
Tags
IRIS
•
Dioxin (2012 Project Page for Final Report)
•
Hexabromocyclododecane (HBCD)
Guidance/contextual references added during assessment development
OPPT REs
•
OPPT_Cyclic Aliphatic Bromine Cluster (HBCD)_C. Engineering
Data screening total
Screening: Excluded
•
OPPT_Cyclic Aliphatic Bromine Cluster (HBCD)_D. Exposure
Total – title/abstract screening
Off topic
•
OPPT_Cyclic Aliphatic Bromine Cluster (HBCD)_E. Fate
Total – title/abstract screening
Off topic
•
OPPT_Cyclic Aliphatic Bromine Cluster (HBCD)_F. Human Health
Total – title/abstract screening
Off topic
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