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This study examined the relationships between maternal thyroid dysfunction during pregnancy and child neurodevelopmental outcomes. Participants were from a high ASD likelihood pregnancy cohort (MARBLES). Maternal thyroid dysfunction (hypothyroid or hyperthyroid compared to euthyroid) was measured in up to one blood sample per trimester. Thyroid stimulating hormone (TSH) and free thyroxine (FT4) were also examined as exposures. Outcomes were child ASD diagnosis, non\u2010typical development (non\u2010TD), typical development and standardized scores from the Social Responsiveness Scale (SRS). Outcomes were confirmed by study psychometricians. Multinomial logistic and quintile regressions were used to examine associations of maternal thyroid dysfunction (using trimester\u2010specific reference ranges) with developmental outcomes and SRS scores. Among 285 pregnancies, 83.9% were categorized as euthyroid, 9.5% hypothyroid, and 6.7% hyperthyroid. Of 285 children included in analyses, 28.8% were diagnosed with ASD (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200982; female\u2009=\u200927) and 14.7% with non\u2010TD (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200942; female\u2009=\u200919). Maternal hypothyroid conditions were associated with increased ASD:TD odds (adjusted RRR\u2009=\u20093.40, 95% CI: 1.22, 9.45;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.02). Significant relationships were also found between hypothyroid conditions and non\u2010TD, and between first trimester TSH and ASD. There was no evidence of a relationship between either TSH or FT4 and preschool SRS scores. Findings suggest that maternal hypothyroid conditions during pregnancy are associated with greater chances of their children developing ASD and other neurodevelopmental differences among children with high familial likelihood of ASD.\n                  <\/jats:p>","DOI":"10.1002\/aur.70346","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T05:12:46Z","timestamp":1786597966000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal Thyroid Dysfunction During Pregnancy and Childhood Autism or Other Developmental Outcomes"],"prefix":"10.1002","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5495-1766","authenticated-orcid":false,"given":"Zoe B.","family":"Kaplan","sequence":"first","affiliation":[{"name":"Public Health Sciences University of California  Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3799-0354","authenticated-orcid":false,"given":"Elizabeth N.","family":"Pearce","sequence":"additional","affiliation":[{"name":"Department of Medicine Boston University Chobanian and Avedisian School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Psychiatry &amp; Behavioral Sciences University of California  Davis California USA"},{"name":"University of California Davis, MIND Institute  Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3884-7907","authenticated-orcid":false,"given":"Daniel","family":"Tancredi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California, Davis School of Medicine  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irva","family":"Hertz\u2010Picciotto","sequence":"additional","affiliation":[{"name":"Public Health Sciences University of California  Davis California USA"},{"name":"University of California Davis, MIND Institute  Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7001-2555","authenticated-orcid":false,"given":"Hyeong\u2010Moo","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Environmental Science Baylor University  Waco Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1582-2747","authenticated-orcid":false,"given":"Rebecca J.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Public Health Sciences University of California  Davis California USA"},{"name":"University of California Davis, MIND Institute  Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0457"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jms.7.3.127"},{"issue":"30","key":"e_1_2_10_4_1","first-page":"1","article-title":"Imputation of Categorical Variables With PROC MI","volume":"113","author":"Allison P. 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