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Association Between Maternal Thyroid Hormones and Birth Weight at Early and Late Pregnancy

Chen Zhang  Xi Yang  Yong Zhang  Fei Guo  Shuai Yang  Robin P.Peeters  Tim I.M.Korevaar  He-Feng Huang  Jianxia Fan  
【摘要】:Context: Previous studies suggest that maternal thyroid function affects fetal growth, while the association between combined thyroid hormones from early to late pregnancy and newborn birth weight remains unknown.Objective: To explore the association of maternal thyroid function during early and late pregnancy with birth weight.Design: A large prospective cohort study of a Chinese population.Setting: This study recruited pregnant women who underwent first trimester prenatal screenings at the International Peace Maternity and Child Health Hospital between January 2013 and December 2016.Participants: This study enrolled 46,186 mothers in whom thyroid stimulating hormone(TSH), free thyroxine(FT4), triiodothyronine(T3) and TPOAbs concentrations were measured in the first and third trimester and in whom data on birth weight were available.Main Outcome Measures: Birth weight, small for gestation age(SGA), large for gestation age(LGA).Results: A higher TSH or FT4 concentration, as well as a lower T3 concentration, during the 1 st or 3 rd trimester was associated with a lower birth weight. The lowest percentiles of maternal FT4(FT4 2.5 th percentile) in both trimesters were associated with a 0.34 SD higher birth weight. The effect estimates were greater in those only in 1 st trimester(0.23 SD) or in 3 rd trimester(0.17 SD). The association of maternal TSH and FT4 with birth weight differed according to fetal sex.Conclusions: Persistently low FT4 concentrations throughout pregnancy were associated with higher birth weight and an increased risk of LGA. Based on these findings we recommend monitoring of mildly altered concentrations of thyroid hormone throughout pregnancy.Precis: Our results indicate that low maternal FT4 and high maternal T3 concentrations are associated with a higher risk of LGA newborns, with additive effects for persistency of high FT4 from early to late pregnancy.

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