The Impact Of Thyrotoxicosis In The Early Stage Of Pregnancy On Intelligence Development Of The Offspring And Analysis Of The Related Factors

Objectives: By comparing the scores of early-pregnancy maternal thyrotoxicosis and the offspring of the normal group with C-WYCSI,to explore the changes in the intellectual development level of the maternal thyrotoxic offspring in early pregnancy and the intelligence development of the offspring of the normal group,as well as the maternal thyroid function of the influence of offspring intelligence and related factors.Methods: The follow-ups were from the study group of “Iodine iron deficiency and subclinical thyroid hormone deficiency in early pregnancy: screening and intervention”project(SHEP item)during May 2011 to October 2014.The screening requirements including 52 pregnant women with Graves' disease and gestational transient thyrotoxicosis(GTT)in the first trimester.There were 16 person in the GD group,with 7patients received clinical treatment of antithyroid drugs,while 9 patients rejected anti-thyroid drugs and 36 person in the GTT group,46 pregnant women in the normal group.The offspring of all respondents were received Chinese Wechsler Young Children Scale of Intelligence(C-WYCSI)at their age of 4-6.5 years.Statistical analysis was used to analyze age,fetal sex,Apgar score,delivery timing,abortion history,and birth history,birth pattern,parental education,family total income,early pregnancy thyroid stimulating hormone(TSH),thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb)and offspring's intelligence IQ value,and the GD group and GTT group were analyzed separately.All the data were analyzed by statistical T test,and the Logistic regression model was used to analyze multiple factors with statistical significance.Results: In early pregnancy,the IQ values of the offspring of the GTT group,the GD group,and the normal control group were 105.00 ± 3.76,103.38 ± 2.80,and 105.96 ±3.55,respectively.The IQ value was significantly lower than the normal group,and the difference between the GD group and the GTT group was statistically significant(p =0.034).The speech scale test results of Wechsler Intelligence Scale showed that the GTT group and the Graves group were reduced compared with the control group,but only the difference between the Graves disease group and the normal group was statistically significant(p = 0.041);There was no statistically significant difference between GD and GTT group(p = 0.74).In the operation scale,the score of the GTT group was not significantly different from that of the control group(p = 0.85),and the score of the GD group was lower than that of the control group(p = 0.091),but did not reach a statistically significant difference.Analysis of related factors found that TPOAb or TGAb positive was negatively related to total IQ value and IQ value of speech scale,and parental education and family monthly income were related to IQ score.Conclusions: The offspring of GD and GTT mothers in early pregnancy have different degrees of IQ decline compared with the normal control group.The speech scale is mainly used to indicate that maternal thyroidism in early pregnancy,especially with TPOAb or TGAb positive may also affect the fetal nervous system development,language expression,cognitive and memory etc.Therefore,maternal thyroid function and autoantibodies need to be screened in early pregnancy to reduce the risk of low IQ in offspring.