CATS II Long-term Anthropometric and Metabolic Effects of Maternal Sub-optimal Thyroid Function in Offspring and Mothers.

Journal: The Journal of clinical endocrinology and metabolism

Volume: 105

Issue: 7

Year of Publication: 2021

Affiliated Institutions:  Thyroid Research Group, Division of Infection & Immunity, School of Medicine, Cardiff University, Cardiff, UK. Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK. MRC The Gambia at the London School of Hygiene and Tropical Medicine, London, UK. Radiology, Medical Physics and Clinical Engineering Directorate, University Hospital of Wales, Cardiff, UK. Neuroscience and Mental Health Research Institute, School of Medicine, Cardiff University, Cardiff, UK.

Abstract summary 

The Controlled Antenatal Thyroid Screening Study I (CATS-I) was a randomized controlled trial investigating the effects of levothyroxine therapy for suboptimal gestational thyroid function (SGTF), comparing outcomes in children of treated (SGTF-T) with untreated (SGTF-U) women during pregnancy. This follow-up study, CATS-II, reports the long-term effects on anthropometric, bone, and cardiometabolic outcomes in mothers and offspring and includes a group with normal gestational thyroid function (NGTF).332 mothers (197 NGTF, 56 SGTF-U, 79 SGTF-T) aged 41.2±5.3 years (mean±SD) and 326 paired children assessed 9.3±1.0 years after birth for (i) body mass index (BMI); (ii) lean, fat, and bone mass by dual-energy X-ray absorptiometry; (iii) blood pressure, augmentation index, and aortic pulse-wave-velocity; and (iv) thyroid function, lipids, insulin, and adiponectin. The difference between group means was compared using linear regression.Offspring's measurements were similar between groups. Although maternal BMI was similar between groups at CATS-I, after 9 years (at CATS-II) SGTF-U mothers showed higher BMI (median [interquartile ratio] 28.3 [24.6-32.6] kg/m2) compared with NGTF (25.8 [22.9-30.0] kg/m2; P = 0.029), driven by fat mass increase. At CATS-II SGTF-U mothers also had higher thyroid-stimulating hormone (TSH) values (2.45 [1.43-3.50] mU/L) than NGTF (1.54 [1.12-2.07] mU/L; P = 0.015), since 64% had never received levothyroxine. At CATS-II, SGTF-T mothers had BMI (25.8 [23.1-29.8] kg/m2, P = 0.672) and TSH (1.68 [0.89-2.96] mU/L; P = 0.474) values similar to NGTF mothers.Levothyroxine supplementation of women with SGTF did not affect long-term offspring anthropometric, bone, and cardiometabolic measurements. However, absence of treatment was associated with sustained long-term increase in BMI and fat mass in women with SGTF.

Authors & Co-authors:  Muller Ilaria I Taylor Peter N PN Daniel Rhian M RM Hales Charlotte C Scholz Anna A Candler Toby T Pettit Rebecca J RJ Evans William D WD Shillabeer Dionne D Draman Mohd S MS Dayan Colin M CM Tang Hiu K C HKC Okosieme Onyebuchi O Gregory John W JW Lazarus John H JH Rees D Aled DA Ludgate Marian E ME

Study Outcome 

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Statistics
Citations : 
Authors :  17
Identifiers
Doi : dgaa129
SSN : 1945-7197
Study Population
Women,Mothers
Mesh Terms
Absorptiometry, Photon
Other Terms
BMI;hypothyroidism;metabolism;obesity;pregnancy;thyroid
Study Design
Study Approach
Country of Study
Publication Country
United States