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J Clin Endocrinol Metab. 2014 Nov;99(11):4291-8. doi: 10.1210/jc.2014-1901. Epub 2014 Jul 24.

Maternal perchlorate levels in women with borderline thyroid function during pregnancy and the cognitive development of their offspring: data from the Controlled Antenatal Thyroid Study.

Author information

1
Thyroid Research Group (P.N.T., O.E.O., C.H., C.M.D., J.H.L.), Institute of Molecular and Experimental Medicine, Cardiff University School of Medicine, Cardiff, United Kingdom CF14 4XN; Department of Paediatric Psychology (R.M., R.P., S.C.), St. David's Children's Centre, Cardiff, United Kingdom CF11 9XB; Città della Salute e della Scienza - Ospedale Sant'Anna (E.C., A.M.,), Turin, Italy 10100; Wolfson Institute of Preventive Medicine (M.J., J.P.B.), Barts and the London School of Medicine and Dentistry, London, United Kingdom B15 2TT; University College Dublin School of Medicine (P.S.), University College, Dublin, Ireland, Dublin 4; and Section of Endocrinology, Diabetes, and Nutrition (L.E.B., E.N.P.), Boston University School of Medicine, Boston, Massachusetts.

Abstract

OBJECTIVE:

Thyroid dysfunction is associated with impaired cognitive development. Perchlorate decreases thyroidal iodine uptake, potentially reducing thyroid hormone production. It is unclear whether perchlorate exposure in early life affects neurodevelopment.

DESIGN:

Historical cohort analysis.

PATIENTS:

From 2002 to 2006, 21,846 women at gestational age <16 weeks recruited from antenatal clinics in Cardiff, UK and Turin, Italy were enrolled in the Controlled Antenatal Thyroid Screening Study (CATS). We undertook a retrospective analysis of 487 mother-child pairs in mothers who were hypothyroid/hypothyroxinemic during pregnancy and analyzed whether first trimester maternal perchlorate levels in the highest 10% of the study population were associated with increased odds of offspring IQ being in the lowest 10% at 3 years of age.

MAIN OUTCOME MEASURES:

Maternal urinary perchlorate, offspring IQ.

RESULTS:

Urine perchlorate was detectable in all women (median 2.58 μg/L); iodine levels were low (median 72 μg/L). Maternal perchlorate levels in the highest 10% of the population increased the odds of offspring IQ being in the lowest 10% OR = 3.14 (95% CI 1.38, 7.13) P = .006 with a greater negative impact observed on verbal OR = 3.14 (95% CI 1.42, 6.90) P = .005 than performance IQ. Maternal levothyroxine therapy did not reduce the negative impact of perchlorate on offspring IQ.

CONCLUSIONS:

This is the first study using individual-level patient data to study maternal perchlorate exposure and offspring neurodevelopment and suggests that high-end maternal perchlorate levels in hypothyroid/hypothyroxinemic pregnant women have an adverse effect on offspring cognitive development, not affected by maternal levothyroxine therapy. These results require replication in additional studies, including in the euthyroid population.

PMID:
25057878
DOI:
10.1210/jc.2014-1901
[Indexed for MEDLINE]

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