Just because most of us have been on holidays doesn’t mean the thyroid knowledge wagon has stopped or even slowed! Always amazed at what we continue to discover about the complex working of this amazing gland and how its health impacts so much of the rest of the body and of course our babies’ bodies! So I thought I’d give you a quick recap of an important study published while you were at the beach/in the bush/in bed ;)…
- A Finnish prospective cohort study of over 3000 pregnancies by Heikkinnen et al has revealed that at 16yo, offspring from these pregnancies, had a 1.56 increased rate of unhealthy weight and a 2.5 greater likelihood of meeting criteria for metabolic syndrome, if their mothers were thyroperoxidase antibody (TPO) positive during their first trimester
- TPO antibodies affect up to 20% of pregnancies but in this study they defined ‘TPO positive’ as those women with levels ≥ 167.7 IU/mL (the 95th centile in this sample)
- What adds to the noteworthiness of this news is that:
- More than half (55%) of the TPO positive mothers were classified as euthyroid during their pregnancy, suggesting that the effect was not driven by maternal hormone concentrations
- The offspring of mothers with actual thyroid dysfunction did not show any statistically significantly greater risk of cardiometabolic issues
- The offspring of hyperthyroid mothers in fact demonstrated significantly better insulin sensitivity at 16yo than children of euthyroid mothers
- Thyroglobulin Abs over the 95th centile (≥ 47.7 IU/mL) did not correlate with any increase in cardiometabolic risks for their children
When we consider the substantial evidence of poorer maternal cardiometabolic outcomes for women who are hypothyroid during pregnancy – it would seem that the abnormal thyroid hormones are most impacting for mum but in fact the TPO Abs the most detrimental for bub!
The abstract for this study can be found here but if you’re a Medscape member (remember this is a free medical news service that is ACE, so if you’re not yet then get into it for 2018!) then you can read virtually the full text article on the Medscape platform.
Some really good food for thought on the broad reaching tentacles of thyroid dysfunction and autoimmunity, and our approach to preconception & pregnancy care – that really challenges our assumptions of what constitutes a healthy thyroid…AGAIN! 🙂
Thyroid health is integral to fertility and optimal pregnancy outcomes yet thyroid physiology changes dramatically during both gestation and the post-partum period, reducing the confidence of some clinicians. This recording covers the absolute must-knows about thyroid markers prior to conception and trimester specific knowledge regarding thyroid physiology. What do we risk if thyroid imbalance goes unrecognised – for baby? for mum? and how can we better prevent against this? Better clinician assessment translates into improved diagnosis, management and pregnancy outcomes for mother and baby.
In this 1.5hr recording Rachel reviews the key landmarks for recognising both thyroid adequacy and optimisation in regard to female fertility, healthy offspring and the best maternal outcomes post-partum.