Chronic diseases in the children of women with maternal thyroid dysfunction: a nationwide cohort study

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Abstract

Objective: Maternal thyroid disease (TD) during pregnancy is associated with adverse birth outcomes, but little is known on its long-term outcomes. We aimed to examine if children born to mothers with TD have increased disease risk during childhood and adolescence.

Patients and methods: A register-based cohort study was conducted on all live born children in Denmark from 1989 to 2013, including the association between maternal TD during pregnancy and somatic and psychiatric diseases in the children. Cox proportional hazards models were used to compute hazard ratios (HRs) according to the type of maternal TD, Graves' disease, and Hashimoto's thyroiditis.

Results: A total of 2,618 children were born to women with Graves' disease, 760 to women with Hashimoto's thyroiditis (exposed), and 1,557,577 to women without any TD (unexposed). The median follow-up time for children born to mothers with Graves' disease was 9.3 years (25/75 percentile 5.4/13.9 years) and with Hashimoto's thyroiditis was 4.8 years (25/75 percentile 2.5/8.2 years). In children exposed to maternal Graves' disease in utero, the adjusted HR of TD was 12.83 (95% CI, 9.74-16.90), Graves' disease was 34.3 (95% CI, 20.23-58.35), and type 1 was diabetes 2.47 (95% CI, 1.46-4.18). In children exposed to maternal Hashimoto's thyroiditis, the adjusted HR of Hashimoto's thyroiditis was 24.04 (95% CI, 5.89-97.94).

Conclusion: Our data suggest that children born to women with Graves' disease and Hashimoto's thyroiditis have excess long-term morbidities in childhood and adolescence. We particularly found an increased risk of any TD and type 1 diabetes to be diagnosed in children exposed in utero to Graves' disease. These novel findings are relevant for pediatricians, stressing the importance of history of maternal disease when evaluating children with suspected endocrine disorders.

Original languageEnglish
JournalClinical Epidemiology
Volume10
Pages (from-to)1381-1390
ISSN1179-1349
DOIs
Publication statusPublished - 1. Jan 2018

Fingerprint

Cohort Studies
Hashimoto Disease
Mothers
Denmark
Proportional Hazards Models

Keywords

  • Child morbidity
  • Clinical epidemiology
  • Graves’ disease
  • Hashimoto’s thyroiditis
  • Reproduction
  • Thyroid disease

Cite this

@article{fb5f048601f74339844328b9111fd344,
title = "Chronic diseases in the children of women with maternal thyroid dysfunction: a nationwide cohort study",
abstract = "Objective: Maternal thyroid disease (TD) during pregnancy is associated with adverse birth outcomes, but little is known on its long-term outcomes. We aimed to examine if children born to mothers with TD have increased disease risk during childhood and adolescence.Patients and methods: A register-based cohort study was conducted on all live born children in Denmark from 1989 to 2013, including the association between maternal TD during pregnancy and somatic and psychiatric diseases in the children. Cox proportional hazards models were used to compute hazard ratios (HRs) according to the type of maternal TD, Graves' disease, and Hashimoto's thyroiditis.Results: A total of 2,618 children were born to women with Graves' disease, 760 to women with Hashimoto's thyroiditis (exposed), and 1,557,577 to women without any TD (unexposed). The median follow-up time for children born to mothers with Graves' disease was 9.3 years (25/75 percentile 5.4/13.9 years) and with Hashimoto's thyroiditis was 4.8 years (25/75 percentile 2.5/8.2 years). In children exposed to maternal Graves' disease in utero, the adjusted HR of TD was 12.83 (95{\%} CI, 9.74-16.90), Graves' disease was 34.3 (95{\%} CI, 20.23-58.35), and type 1 was diabetes 2.47 (95{\%} CI, 1.46-4.18). In children exposed to maternal Hashimoto's thyroiditis, the adjusted HR of Hashimoto's thyroiditis was 24.04 (95{\%} CI, 5.89-97.94).Conclusion: Our data suggest that children born to women with Graves' disease and Hashimoto's thyroiditis have excess long-term morbidities in childhood and adolescence. We particularly found an increased risk of any TD and type 1 diabetes to be diagnosed in children exposed in utero to Graves' disease. These novel findings are relevant for pediatricians, stressing the importance of history of maternal disease when evaluating children with suspected endocrine disorders.",
keywords = "Child morbidity, Clinical epidemiology, Graves’ disease, Hashimoto’s thyroiditis, Reproduction, Thyroid disease",
author = "J{\o}lving, {Line Riis} and Jan Nielsen and Kesmodel, {Ulrik Schi{\o}ler} and Nielsen, {Rasmus Gaardsk{\ae}r} and N{\o}rg{\aa}rd, {Bente Mertz} and Beck-Nielsen, {Signe Sparre}",
year = "2018",
month = "1",
day = "1",
doi = "10.2147/CLEP.S167128",
language = "English",
volume = "10",
pages = "1381--1390",
journal = "Clinical Epidemiology",
issn = "1179-1349",
publisher = "Dove Medical Press Ltd.(Dovepress)",

}

Chronic diseases in the children of women with maternal thyroid dysfunction : a nationwide cohort study. / Jølving, Line Riis; Nielsen, Jan; Kesmodel, Ulrik Schiøler; Nielsen, Rasmus Gaardskær; Nørgård, Bente Mertz; Beck-Nielsen, Signe Sparre.

In: Clinical Epidemiology, Vol. 10, 01.01.2018, p. 1381-1390.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Chronic diseases in the children of women with maternal thyroid dysfunction

T2 - a nationwide cohort study

AU - Jølving, Line Riis

AU - Nielsen, Jan

AU - Kesmodel, Ulrik Schiøler

AU - Nielsen, Rasmus Gaardskær

AU - Nørgård, Bente Mertz

AU - Beck-Nielsen, Signe Sparre

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective: Maternal thyroid disease (TD) during pregnancy is associated with adverse birth outcomes, but little is known on its long-term outcomes. We aimed to examine if children born to mothers with TD have increased disease risk during childhood and adolescence.Patients and methods: A register-based cohort study was conducted on all live born children in Denmark from 1989 to 2013, including the association between maternal TD during pregnancy and somatic and psychiatric diseases in the children. Cox proportional hazards models were used to compute hazard ratios (HRs) according to the type of maternal TD, Graves' disease, and Hashimoto's thyroiditis.Results: A total of 2,618 children were born to women with Graves' disease, 760 to women with Hashimoto's thyroiditis (exposed), and 1,557,577 to women without any TD (unexposed). The median follow-up time for children born to mothers with Graves' disease was 9.3 years (25/75 percentile 5.4/13.9 years) and with Hashimoto's thyroiditis was 4.8 years (25/75 percentile 2.5/8.2 years). In children exposed to maternal Graves' disease in utero, the adjusted HR of TD was 12.83 (95% CI, 9.74-16.90), Graves' disease was 34.3 (95% CI, 20.23-58.35), and type 1 was diabetes 2.47 (95% CI, 1.46-4.18). In children exposed to maternal Hashimoto's thyroiditis, the adjusted HR of Hashimoto's thyroiditis was 24.04 (95% CI, 5.89-97.94).Conclusion: Our data suggest that children born to women with Graves' disease and Hashimoto's thyroiditis have excess long-term morbidities in childhood and adolescence. We particularly found an increased risk of any TD and type 1 diabetes to be diagnosed in children exposed in utero to Graves' disease. These novel findings are relevant for pediatricians, stressing the importance of history of maternal disease when evaluating children with suspected endocrine disorders.

AB - Objective: Maternal thyroid disease (TD) during pregnancy is associated with adverse birth outcomes, but little is known on its long-term outcomes. We aimed to examine if children born to mothers with TD have increased disease risk during childhood and adolescence.Patients and methods: A register-based cohort study was conducted on all live born children in Denmark from 1989 to 2013, including the association between maternal TD during pregnancy and somatic and psychiatric diseases in the children. Cox proportional hazards models were used to compute hazard ratios (HRs) according to the type of maternal TD, Graves' disease, and Hashimoto's thyroiditis.Results: A total of 2,618 children were born to women with Graves' disease, 760 to women with Hashimoto's thyroiditis (exposed), and 1,557,577 to women without any TD (unexposed). The median follow-up time for children born to mothers with Graves' disease was 9.3 years (25/75 percentile 5.4/13.9 years) and with Hashimoto's thyroiditis was 4.8 years (25/75 percentile 2.5/8.2 years). In children exposed to maternal Graves' disease in utero, the adjusted HR of TD was 12.83 (95% CI, 9.74-16.90), Graves' disease was 34.3 (95% CI, 20.23-58.35), and type 1 was diabetes 2.47 (95% CI, 1.46-4.18). In children exposed to maternal Hashimoto's thyroiditis, the adjusted HR of Hashimoto's thyroiditis was 24.04 (95% CI, 5.89-97.94).Conclusion: Our data suggest that children born to women with Graves' disease and Hashimoto's thyroiditis have excess long-term morbidities in childhood and adolescence. We particularly found an increased risk of any TD and type 1 diabetes to be diagnosed in children exposed in utero to Graves' disease. These novel findings are relevant for pediatricians, stressing the importance of history of maternal disease when evaluating children with suspected endocrine disorders.

KW - Child morbidity

KW - Clinical epidemiology

KW - Graves’ disease

KW - Hashimoto’s thyroiditis

KW - Reproduction

KW - Thyroid disease

U2 - 10.2147/CLEP.S167128

DO - 10.2147/CLEP.S167128

M3 - Journal article

C2 - 30310330

VL - 10

SP - 1381

EP - 1390

JO - Clinical Epidemiology

JF - Clinical Epidemiology

SN - 1179-1349

ER -