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Right arrow Endocrinology

AAP Grand Rounds 3:8-9 (2000)
© 2000 American Academy of Pediatrics

ENDOCRINOLOGY

Maternal Thyroid Deficiency is Detrimental to Fetus

Source: Haddow JE, et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med. 1999;341:549–555.

The first 20% of the full text of this article appears below.

Since initiated in the 1970s, neonatal screening programs for congenital hypothyroidism have been wildly successful. The basic premise behind these screening programs has been that thyroxine-dependent brain growth was confined to the first several months of post-natal life, and that thyroxine replacement immediately after birth would prevent mental retardation. The question of whether thyroxine-dependent brain growth in the human begins in pre-natal life has been debated extensively. Despite evidence that some maternal-derived thyroxine crosses the placenta, some argue that the amounts were likely too small to provide protection to the developing fetus.

Haddow et al provide compelling evidence relevant to this debate. They obtained serum TSH measurements on serum samples collected during the second trimester from 25,216 pregnant women between 1987 and 1990 as part of a screening program for open neural-tube defects and Down syndrome in the State of Maine. These results were correlated with measures of cognitive and neuropsychologic . . . [Full Text of this Article]

Stephen LaFranchi, MD, FAAP
Pediatrics, Oregon Health Sciences University, Portland, OR