{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:19:01Z","timestamp":1760239141121,"version":"build-2065373602"},"reference-count":38,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T00:00:00Z","timestamp":1600732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Robert C. Byrd Center for Rural Health, Marshall University. Funding for the Rural Health Initiative grant comes from the West Virginia Higher Education Policy Commission and the  Marshall University School of Medicine Translational Research Pilot Grant","award":["No identifying number"],"award-info":[{"award-number":["No identifying number"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Thyroid disorders are a frequently encountered issue during pregnancy and a cause of maternal and fetal morbidity. In regions like Appalachia that are particularly susceptible to health disparities, descriptive studies are needed to assist in identifying pathologic derangements. We sought to characterize fetal thyroid hormone levels at delivery and investigate whether or not maternal demographic characteristics affect the prevalence of neonatal thyroid disease. A cross-sectional analysis was conducted on 130 pregnant women recruited from the Tri-State region, incorporating areas of Kentucky, Ohio, and West Virginia. Total triiodothyronine (T3) (p = 0.4799), free T3 (p = 0.6323), T3 uptake (p = 0.0926), total thyroxine (T4) (p = 0.8316), free T4 (p = 0.0566), and Thyroid stimulating hormone (TSH) (p = 0.8745) levels were comparable between urban and rural newborns. We found no effect of hypertension status or nicotine levels on fetal umbilical cord thyroid hormone levels. Maternal diabetic status was associated with lower T4 (p = 0.0099) and free T4 (p = 0.0025) levels. Cotinine affected levels of T4 (p = 0.0339). In regard to maternal Body Mass Index (BMI), there was an increase in total T3 as BMI increased (p = 0.0367) and no significant difference in free T3, T3 uptake, T4, free T4, or TSH. There was a negative correlation between TSH and 1 min Apgar scores (p = 0.0058). Lead and cadmium have been implicated to alter TSH levels, but no correlation was found in our study (r2 = 0.0277). There were no differences in cord blood between urban (37.3 \u00b1 10.3 fmol\/ug DNA) and rural (70.5 \u00b1 26.8 fmol\/ug DNA) benzo(a)pyrene DNA adducts (p = 0.174). Thyroid disorders present a unique opportunity for the prevention of perinatal morbidity and mortality, since maternal treatment, as well as maternal demographic characteristics, can have direct fetal effects.<\/jats:p>","DOI":"10.3390\/jcm9093056","type":"journal-article","created":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T02:56:43Z","timestamp":1600916203000},"page":"3056","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Characterization of Fetal Thyroid Levels at Delivery among Appalachian Infants"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1774-7859","authenticated-orcid":false,"given":"Madison N.","family":"Crank","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25755-9310, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0247-5443","authenticated-orcid":false,"given":"Jesse N.","family":"Cottrell","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25755-9310, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda L.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25755-9310, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7065-5721","authenticated-orcid":false,"given":"Monica A.","family":"Valentovic","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Pharmacology\/Toxicology Research Cluster, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25755-9310, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,22]]},"reference":[{"key":"ref_1","unstructured":"(2020). Thyroid Disease in Pregnancy. ACOG Practice Bulletin No. 223, American College of Obstetricians and Gynecologists."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S167","DOI":"10.4103\/2230-8210.104031","article-title":"Thyroid disorders in pregnancy","volume":"16","author":"Ramprasad","year":"2012","journal-title":"Indian J. Endocrinol. 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