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Protocol of the PSYCHOTSH study: association between neonatal thyroid stimulating hormone concentration and intellectual, psychomotor and psychosocial development at 4-5 year of age: a retrospective cohort study.

Trumpff C, Vanderfaeillie J, Vercruysse N, De Schepper J, Tafforeau J, Van Oyen H, Vandevijvere S - Arch Public Health (2014)

Bottom Line: In several studies, elevated TSH levels at birth were associated with suboptimal cognitive and psychomotor outcomes among young children.In addition, several socioeconomic, parental and child confounding factors are assessed.Therefore, the results may have important implications for future public health recommendations, policies and practices in food supplementation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Unit of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium ; Faculté des Sciences Psychologiques et de l'Education, Université Libre de Bruxelles, Brussels, Belgium.

ABSTRACT

Background: Several European countries, including Belgium, still suffer from mild iodine deficiency. Thyroid stimulating hormone (TSH) concentration in whole blood measured at birth has been proposed as an indicator of maternal iodine status during the last trimester of pregnancy. It has been shown that mild iodine deficiency during pregnancy may affect the neurodevelopment of the offspring. In several studies, elevated TSH levels at birth were associated with suboptimal cognitive and psychomotor outcomes among young children. This paper describes the protocol of the PSYCHOTSH study aiming to assess the association between neonatal TSH levels and intellectual, psychomotor and psychosocial development of 4-5 year old children. The results could lead to a reassessment of the recommended cut-off levels of 5 > mU/L used for monitoring iodine status of the population.

Methods: In total, 380 Belgian 4-5 year old preschool children from Brussels and Wallonia with a neonatal blood spot TSH concentration between 0 and 15 mU/L are included in the study. For each sex and TSH-interval (0-1, 1-2, 2-3, 3-4, 4-5, 5-6, 6-7, 7-8, 8-9 and 9-15 mU/L), 19 newborns were randomly selected from all newborns screened by the neonatal screening centre in Brussels in 2008-2009. Infants with congenital hypothyroidism, low birth weight and prematurity were excluded from the study. Neonatal TSH concentration was measured by the Autodelphia method in dried blood spots, collected by heel stick on filter paper 3 to 5 days after birth. Cognitive abilities and psychomotor development are assessed using the Wechsler Preschool and Primary Scale of Intelligence - third edition - and the Charlop-Atwell Scale of Motor coordination. Psychosocial development is measured using the Child Behaviour Check List for age 1½ to 5 years old. In addition, several socioeconomic, parental and child confounding factors are assessed.

Conclusions: This study aims to clarify the effect of mild iodine deficiency during pregnancy on the neurodevelopment of the offspring. Therefore, the results may have important implications for future public health recommendations, policies and practices in food supplementation. In addition, the results may have implications for the use of neonatal TSH screening results for monitoring the population iodine status and may lead to the definition of new TSH cut-offs for determination of the severity of iodine status and for practical use in data reporting by neonatal screening centres.

No MeSH data available.


Related in: MedlinePlus

Neonatal thyroid stimulating hormone concentration as indicator of maternal iodine deficiency.Legend: In the thyroid gland, thyroid hormones (TH) T3 and T4 are produced from association of tyrosine and iodine. Liberation of thyroid stimulating hormones (TSH) stimulates TH production and secretion. The lack of TH in the bloodstream leads to the liberation of thyrotropin-releasing hormone (TRH) from the hypothalamus. TRH stimulates the liberation of TSH by the pituitary gland. A - In situation of maternal iodine sufficiency, iodine stocks are sufficient to produce adapted amount of TH and TSH release is inhibited by negative feedback inhibition. B - In situation of maternal iodine deficiency, iodine stocks are insufficient to produce adapted quantity of TH and TSH release is maintained leading to increased TSH concentration in bloodstream.
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Figure 1: Neonatal thyroid stimulating hormone concentration as indicator of maternal iodine deficiency.Legend: In the thyroid gland, thyroid hormones (TH) T3 and T4 are produced from association of tyrosine and iodine. Liberation of thyroid stimulating hormones (TSH) stimulates TH production and secretion. The lack of TH in the bloodstream leads to the liberation of thyrotropin-releasing hormone (TRH) from the hypothalamus. TRH stimulates the liberation of TSH by the pituitary gland. A - In situation of maternal iodine sufficiency, iodine stocks are sufficient to produce adapted amount of TH and TSH release is inhibited by negative feedback inhibition. B - In situation of maternal iodine deficiency, iodine stocks are insufficient to produce adapted quantity of TH and TSH release is maintained leading to increased TSH concentration in bloodstream.

Mentions: Thyroid stimulating hormone (TSH) concentration in whole blood measured at birth has been proposed as an indicator of maternal iodine status during the last trimester of pregnancy[11]. TSH controls and stimulates the production of TH. In order to maintain circulating TH levels within the required range, TSH is secreted. If iodine stores are insufficient to produce TH, TSH concentration increases. Figure 1 illustrates the change in neonatal TSH concentration in case of maternal iodine sufficiency or deficiency during pregnancy.


Protocol of the PSYCHOTSH study: association between neonatal thyroid stimulating hormone concentration and intellectual, psychomotor and psychosocial development at 4-5 year of age: a retrospective cohort study.

Trumpff C, Vanderfaeillie J, Vercruysse N, De Schepper J, Tafforeau J, Van Oyen H, Vandevijvere S - Arch Public Health (2014)

Neonatal thyroid stimulating hormone concentration as indicator of maternal iodine deficiency.Legend: In the thyroid gland, thyroid hormones (TH) T3 and T4 are produced from association of tyrosine and iodine. Liberation of thyroid stimulating hormones (TSH) stimulates TH production and secretion. The lack of TH in the bloodstream leads to the liberation of thyrotropin-releasing hormone (TRH) from the hypothalamus. TRH stimulates the liberation of TSH by the pituitary gland. A - In situation of maternal iodine sufficiency, iodine stocks are sufficient to produce adapted amount of TH and TSH release is inhibited by negative feedback inhibition. B - In situation of maternal iodine deficiency, iodine stocks are insufficient to produce adapted quantity of TH and TSH release is maintained leading to increased TSH concentration in bloodstream.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4150557&req=5

Figure 1: Neonatal thyroid stimulating hormone concentration as indicator of maternal iodine deficiency.Legend: In the thyroid gland, thyroid hormones (TH) T3 and T4 are produced from association of tyrosine and iodine. Liberation of thyroid stimulating hormones (TSH) stimulates TH production and secretion. The lack of TH in the bloodstream leads to the liberation of thyrotropin-releasing hormone (TRH) from the hypothalamus. TRH stimulates the liberation of TSH by the pituitary gland. A - In situation of maternal iodine sufficiency, iodine stocks are sufficient to produce adapted amount of TH and TSH release is inhibited by negative feedback inhibition. B - In situation of maternal iodine deficiency, iodine stocks are insufficient to produce adapted quantity of TH and TSH release is maintained leading to increased TSH concentration in bloodstream.
Mentions: Thyroid stimulating hormone (TSH) concentration in whole blood measured at birth has been proposed as an indicator of maternal iodine status during the last trimester of pregnancy[11]. TSH controls and stimulates the production of TH. In order to maintain circulating TH levels within the required range, TSH is secreted. If iodine stores are insufficient to produce TH, TSH concentration increases. Figure 1 illustrates the change in neonatal TSH concentration in case of maternal iodine sufficiency or deficiency during pregnancy.

Bottom Line: In several studies, elevated TSH levels at birth were associated with suboptimal cognitive and psychomotor outcomes among young children.In addition, several socioeconomic, parental and child confounding factors are assessed.Therefore, the results may have important implications for future public health recommendations, policies and practices in food supplementation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Unit of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium ; Faculté des Sciences Psychologiques et de l'Education, Université Libre de Bruxelles, Brussels, Belgium.

ABSTRACT

Background: Several European countries, including Belgium, still suffer from mild iodine deficiency. Thyroid stimulating hormone (TSH) concentration in whole blood measured at birth has been proposed as an indicator of maternal iodine status during the last trimester of pregnancy. It has been shown that mild iodine deficiency during pregnancy may affect the neurodevelopment of the offspring. In several studies, elevated TSH levels at birth were associated with suboptimal cognitive and psychomotor outcomes among young children. This paper describes the protocol of the PSYCHOTSH study aiming to assess the association between neonatal TSH levels and intellectual, psychomotor and psychosocial development of 4-5 year old children. The results could lead to a reassessment of the recommended cut-off levels of 5 > mU/L used for monitoring iodine status of the population.

Methods: In total, 380 Belgian 4-5 year old preschool children from Brussels and Wallonia with a neonatal blood spot TSH concentration between 0 and 15 mU/L are included in the study. For each sex and TSH-interval (0-1, 1-2, 2-3, 3-4, 4-5, 5-6, 6-7, 7-8, 8-9 and 9-15 mU/L), 19 newborns were randomly selected from all newborns screened by the neonatal screening centre in Brussels in 2008-2009. Infants with congenital hypothyroidism, low birth weight and prematurity were excluded from the study. Neonatal TSH concentration was measured by the Autodelphia method in dried blood spots, collected by heel stick on filter paper 3 to 5 days after birth. Cognitive abilities and psychomotor development are assessed using the Wechsler Preschool and Primary Scale of Intelligence - third edition - and the Charlop-Atwell Scale of Motor coordination. Psychosocial development is measured using the Child Behaviour Check List for age 1½ to 5 years old. In addition, several socioeconomic, parental and child confounding factors are assessed.

Conclusions: This study aims to clarify the effect of mild iodine deficiency during pregnancy on the neurodevelopment of the offspring. Therefore, the results may have important implications for future public health recommendations, policies and practices in food supplementation. In addition, the results may have implications for the use of neonatal TSH screening results for monitoring the population iodine status and may lead to the definition of new TSH cut-offs for determination of the severity of iodine status and for practical use in data reporting by neonatal screening centres.

No MeSH data available.


Related in: MedlinePlus