{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:31:52Z","timestamp":1784309512339,"version":"3.55.0"},"reference-count":68,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2019,9,1]],"date-time":"2019-09-01T00:00:00Z","timestamp":1567296000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Thyroid hormone is essential for optimal fetal brain development. Evidence suggests that both low and high maternal thyroid hormone availability may have adverse effects on child neurodevelopmental outcomes, but the effect on behavioral problems remains unclear. We studied the association of maternal thyrotropin (TSH) and free thyroxine (fT4) concentrations during the first 18 weeks of pregnancy with child attention-deficit hyperactivity disorder (ADHD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A total of 7669 mother\u2013child pairs with data on maternal thyroid function and child ADHD were selected from three prospective population-based birth cohorts: INfancia y Medio Ambiente (INMA;\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u20091073, Spain), Generation R (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u20093812, The Netherlands), and Avon Longitudinal Study of Parents and Children (ALSPAC;\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u20092784, United Kingdom). Exclusion criteria were multiple pregnancy, fertility treatment, usage of medication affecting the thyroid, and pre-existing thyroid disease. We used logistic regression models to study the association of maternal thyroid function with the primary outcome, ADHD, assessed via the\n                      <jats:italic toggle=\"yes\">Diagnostic and Statistical Manual of Mental Disorders, fourth edition<\/jats:italic>\n                      (DSM-IV) criteria by parents and\/or teachers at a median child age of 4.5 to 7.6 years, and with the secondary outcome, an ADHD symptom score above the 90th percentile. Effect modification by gestational age and sex was tested with interaction terms and stratified analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Overall, 233 (3%) children met the criteria for ADHD. When analyzed continuously, neither fT4 nor TSH was associated with a higher risk of ADHD (odds ratio [OR] 1.1, 95% confidence interval [CI 1.0\u20131.3],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.060 and OR 0.9 [CI 0.9\u20131.1],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.385, respectively) or with high symptom scores. When investigating effect modification by gestational age, a higher fT4 was associated with symptoms above the 90th percentile but only in the first trimester (for fT4 per 1 SD: OR 1.2 [CI 1.0\u20131.4],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.027). However, these differential effects by gestational age were not consistent. No significant effect modification by sex was observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We found no clear evidence of an association between maternal thyroid function and child ADHD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2018.0794","type":"journal-article","created":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T03:46:52Z","timestamp":1566272812000},"page":"1316-1326","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":20,"title":["Maternal Thyroid Function in Early Pregnancy and Child Attention-Deficit Hyperactivity Disorder: An Individual-Participant Meta-Analysis"],"prefix":"10.1177","volume":"29","author":[{"given":"Deborah","family":"Levie","sequence":"first","affiliation":[{"name":"The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands."},{"name":"Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands."},{"name":"Department of Child and Adolescent Psychiatry\/Psychology, Erasmus University Medical Centre \u2013 Sophia Children's Hospital, Rotterdam, The Netherlands."},{"name":"Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain."},{"name":"Pompeu Fabra University, Barcelona, Spain."},{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim I.M.","family":"Korevaar","sequence":"additional","affiliation":[{"name":"The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands."},{"name":"Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa A.","family":"Mulder","sequence":"additional","affiliation":[{"name":"The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands."},{"name":"Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands."},{"name":"Department of Child and Adolescent Psychiatry\/Psychology, Erasmus University Medical Centre \u2013 Sophia Children's Hospital, Rotterdam, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah C.","family":"Bath","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Dineva","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Jose","family":"Lopez-Espinosa","sequence":"additional","affiliation":[{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain."},{"name":"Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de Val\u00e8ncia, Valencia, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikel","family":"Basterrechea","sequence":"additional","affiliation":[{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain."},{"name":"Basque Government, Public Health Division of Gipuzkoa, Donostia-San Sebasti\u00e1n, Gipuzkoa, Spain."},{"name":"BIODONOSTIA, Health Research Institute, San Sebastian, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loreto","family":"Santa-Marina","sequence":"additional","affiliation":[{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain."},{"name":"Basque Government, Public Health Division of Gipuzkoa, Donostia-San Sebasti\u00e1n, Gipuzkoa, Spain."},{"name":"BIODONOSTIA, Health Research Institute, San Sebastian, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa","family":"Rebagliato","sequence":"additional","affiliation":[{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain."},{"name":"Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de Val\u00e8ncia, Valencia, Spain."},{"name":"Departmento de Medicina, Universitat Jaume I, Castell\u00f3 de la Plana, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Sunyer","sequence":"additional","affiliation":[{"name":"Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain."},{"name":"Pompeu Fabra University, Barcelona, Spain."},{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain."},{"name":"Hospital del Mar Research Institute (IMIM), Barcelona, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret P.","family":"Rayman","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henning","family":"Tiemeier","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry\/Psychology, Erasmus University Medical Centre \u2013 Sophia 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