Thyroid disease during pregnancy presents no risk for childhood obesity
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Maternal thyroid disease during pregnancy is not associated with adiposity in the child, even though the disease could lead to adiposity for the mother, according to a study published in Clinical Endocrinology.
“We hypothesized that maternal thyroid disease in pregnancy could program the fetus to the development of adiposity in childhood,” Stine Linding Andersen, MD, associate professor in the department of clinical medicine at Aalborg University Hospital in Denmark, and colleagues wrote. “We evaluated the hypothesis among pregnant women and their 7-year-old children from the Danish National Birth Cohort using different designs and different markers of adiposity.”
Researchers analyzed data from two groups of women registered with the Danish National Birth Cohort who gave birth to a singleton first-born child between 1997 and 2003. The first group included women who had thyroid disease during pregnancy identified through a health record showing diagnosis and treatment (n = 40,585). The second group consisted of a 12% random sample of women who had thyroid disease during pregnancy, identified from their thyroid-stimulation hormone measurement (n = 4,255).
At 7-year follow-up, participants filled out a questionnaire about their children that included the child’s height, weight and waist circumference. The children had BMI data available from a health care provider or the parent.
Hypothyroidism diagnosed after pregnancy vs. before or during pregnancy was associated with a small increase in child BMI at age 7 years (adjusted mean difference = 0.16; 95% CI, 0.05-0.28). However, no other associations were found. Pregnancy TSH levels were similar for women whose children had normal weight and overweight at age 7 years. Researchers also found no associations between maternal thyroid disease and a child’s waist circumference at age 7 years. Associations did not change with the severity of the thyroid disease or when the child’s sex, gestational age and birth weight were factored in.
For women who were diagnosed and treated before or during pregnancy, maternal hypothyroidism was associated with prepregnancy overweight (adjusted RR = 1.33; 95% CI, 1.17-1.53) and obesity (aRR = 1.58; 95% CI, 1.21-2.07). Women who had hypothyroidism identified by TSH measurement similarly had an increased risk for prepregnancy overweight (aRR = 1.2; 95% CI, 1.03-1.41) and obesity (aRR = 1.45; 95% CI, 1.07-1.96). Maternal hyperthyroidism was associated with a lower risk for prepregnancy overweight (aRR = 0.79; 95% CI, 0.64-0.98) and obesity (aRR = 0.8; 95% CI, 0.52-1.23).
“Results corroborated an association between maternal thyroid disease in pregnancy and adiposity in the mother and call for further studies to address the clinical impact of deviations in body weight among women with thyroid disease who are or may become pregnant,” researchers wrote. “These findings inform the debate on the management of thyroid disease in pregnant women, including the consequences of abnormal maternal thyroid function for later development of the child and considerations on how and when to diagnose thyroid disease in pregnant women.”
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