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Gestational thyroid hormone concentrations and risk of attention-deficit hyperactivity disorder in the Norwegian Mother, Father and Child Cohort Study.

Publication ,  Journal Article
Engel, SM; Villanger, GD; Herring, A; Nethery, RC; Drover, SSM; Zoeller, RT; Meltzer, HM; Zeiner, P; Knudsen, GP; Reichborn-Kjennerud, T ...
Published in: Paediatric and perinatal epidemiology
March 2023

Maternal thyroid function plays an important role in foetal brain development; however, little consensus exists regarding the relationship between normal variability in thyroid hormones and common neurodevelopmental disorders, such as attention-deficit hyperactivity disorder (ADHD).We sought to examine the association between mid-pregnancy maternal thyroid function and risk of clinically diagnosed ADHD in offspring.We conducted a nested case-control study in the Norwegian Mother, Father and Child Cohort Study. Among children born 2003 or later, we randomly sampled singleton ADHD cases obtained through linkage with the Norwegian Patient Registry (n = 298) and 554 controls. Concentrations of maternal triiodothyronine (T3), thyroxine (T4), T3-Uptake, thyroid-stimulating hormone (TSH) and thyroid peroxidase antibody (TPO-Ab) were measured in maternal plasma, collected at approximately 17 weeks' gestation. Indices of free T4 (FT4i) and free T3 (FT3i) were calculated. We used multivariable adjusted logistic regression to calculate odds ratios and accounted for missing covariate data using multiple imputation. We used restricted cubic splines to assess non-linear trends and provide flexible representations. We examined effect measure modification by dietary iodine and selenium intake. In sensitivity analyses, we excluded women with clinically significant thyroid disorders (n = 73).High maternal T3 was associated with increased risk of ADHD (5th vs 1st quintile odds ratio  2.27, 95% confidence interval 1.21, 4.26). For FT4i, both the lowest and highest quintiles were associated with an approximate 1.6-fold increase in risk of ADHD, with similar trends found for T4. The FT4i association was modified by dietary iodine intake such that the highest risk strata were confined to the low intake group.Both high and low concentrations of maternal thyroid hormones, although within population reference ranges, increase the risk of ADHD in offspring. Increased susceptibility may be found among women with low dietary intake of iodine and selenium.

Duke Scholars

Published In

Paediatric and perinatal epidemiology

DOI

EISSN

1365-3016

ISSN

0269-5022

Publication Date

March 2023

Volume

37

Issue

3

Start / End Page

218 / 228

Related Subject Headings

  • Thyroid Hormones
  • Thyroid Gland
  • Selenium
  • Prenatal Exposure Delayed Effects
  • Pregnancy Trimester, Second
  • Pregnancy Complications
  • Pregnancy
  • Norway
  • Iodine
  • Humans
 

Citation

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Engel, S. M., Villanger, G. D., Herring, A., Nethery, R. C., Drover, S. S. M., Zoeller, R. T., … Aase, H. (2023). Gestational thyroid hormone concentrations and risk of attention-deficit hyperactivity disorder in the Norwegian Mother, Father and Child Cohort Study. Paediatric and Perinatal Epidemiology, 37(3), 218–228. https://doi.org/10.1111/ppe.12941
Engel, Stephanie M., Gro D. Villanger, Amy Herring, Rachel C. Nethery, Samantha S. M. Drover, R Thomas Zoeller, Helle M. Meltzer, et al. “Gestational thyroid hormone concentrations and risk of attention-deficit hyperactivity disorder in the Norwegian Mother, Father and Child Cohort Study.Paediatric and Perinatal Epidemiology 37, no. 3 (March 2023): 218–28. https://doi.org/10.1111/ppe.12941.
Engel SM, Villanger GD, Herring A, Nethery RC, Drover SSM, Zoeller RT, et al. Gestational thyroid hormone concentrations and risk of attention-deficit hyperactivity disorder in the Norwegian Mother, Father and Child Cohort Study. Paediatric and perinatal epidemiology. 2023 Mar;37(3):218–28.
Engel, Stephanie M., et al. “Gestational thyroid hormone concentrations and risk of attention-deficit hyperactivity disorder in the Norwegian Mother, Father and Child Cohort Study.Paediatric and Perinatal Epidemiology, vol. 37, no. 3, Mar. 2023, pp. 218–28. Epmc, doi:10.1111/ppe.12941.
Engel SM, Villanger GD, Herring A, Nethery RC, Drover SSM, Zoeller RT, Meltzer HM, Zeiner P, Knudsen GP, Reichborn-Kjennerud T, Longnecker MP, Aase H. Gestational thyroid hormone concentrations and risk of attention-deficit hyperactivity disorder in the Norwegian Mother, Father and Child Cohort Study. Paediatric and perinatal epidemiology. 2023 Mar;37(3):218–228.
Journal cover image

Published In

Paediatric and perinatal epidemiology

DOI

EISSN

1365-3016

ISSN

0269-5022

Publication Date

March 2023

Volume

37

Issue

3

Start / End Page

218 / 228

Related Subject Headings

  • Thyroid Hormones
  • Thyroid Gland
  • Selenium
  • Prenatal Exposure Delayed Effects
  • Pregnancy Trimester, Second
  • Pregnancy Complications
  • Pregnancy
  • Norway
  • Iodine
  • Humans