Maternal Thyroid Dysfunction During Pregnancy and the Risk of Adverse Outcomes in the Offspring: A Systematic Review and Meta-Analysis

CONTEXT: Previous studies suggested a potential link of maternal thyroid dysfunction with adverse neurocognitive outcomes and impaired development of internal organs in offspring. OBJECTIVE: To review the association between maternal thyroid dysfunction and the risk of adverse outcomes in offspring. DATA SOURCES: PubMed, EMBASE, and Cochrane Library. STUDY SELECTIONS: Eligible studies reported the association between maternal thyroid hormone function and the risk of adverse outcomes in their children. DATA EXTRACTION: Reviewers extracted data on study characteristics and results independently. DATA SYNTHESIS: Estimates were pooled and reported as odds ratio (OR) with 95% confidence interval (CI). I2 tests were applied to assess the heterogeneity across studies. RESULTS: We identified 29 eligible articles and found an association between maternal hyperthyroidism and attention deficit hyperactivity disorder (ADHD) (OR: 1.18, 95% CI: 1.04-1.34, I2 = 0%) and epilepsy (OR: 1.19, 95% CI: 1.08-1.31, I2 = 0%) in offspring; as well as an association of maternal hypothyroidism with increased risk of ADHD (OR: 1.14, 95% CI: 1.03-1.26, I2 = 25%), autism spectrum disorder (OR: 1.41, 95% CI: 1.05-1.90, I2 = 63%), and epilepsy (OR: 1.21, 95% CI: 1.06-1.39, I2 = 0%) in offspring. CONCLUSION: Routine measurement and timely treatment on thyroid function should be considered for pregnant women.