Horm Metab Res 2005; 37(10): 633-640
DOI: 10.1055/s-2005-870533
Original Clinical
© Georg Thieme Verlag KG Stuttgart · New York

Thyroid Hormone Dysregulation in Intrauterine Growth Retardation Associated with Maternal Malnutrition and/or Anemia

S.  D.  Mahajan1 , R.  Aalinkeel1 , S.  Singh2 , P.  Shah1 , N.  Gupta1 , N.  Kochupillai1
  • 1Department of Endocrinology & Metabolism, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
  • 2Department of Obstretrics and Gynecology, Joan C Edwards School of Medicine, Hungtinton, VA, USA
Further Information

Publication History

Received 18 October 2004

Accepted after revision 19 April 2005

Publication Date:
08 November 2005 (online)

Abstract

Data on the effect of maternal malnutrition and/or anemia on thyroid hormone regulation in human fetuses are scarce, and would be of great importance in examining the relevance of Barker’s hypothesis, which proposes adaptation of fetuses to undernutrition leading to permanent metabolic and endocrine changes that form the basis of adult diseases. To examine the quantitative variations in thyroid hormone profile of neonates born to malnourished and/or anemic mothers, we quantitated the T3, T4, rT3 and TSH levels in cord blood of neonates and maternal blood of their corresponding mothers that are malnourished and/or anemic. Further, we classified neonates born to each of these groups of mothers into Small for Gestational Age (SGA) or Appropriate for Gestational Age (AGA) based on the intrauterine growth curve for our population, and examined the thyroid hormone profile in these neonates. Our results show that firstly, the effects of malnutrition or anemia on thyroid hormone profile are distinct, secondly, significantly higher levels of cord blood T4 and correspondingly lower levels of T3 and rT3 are observed in the neonates born to anemic and malnourished mothers and thirdly, decreases in cord blood T3 levels were observed in Small for Gestational Age neonates born to anemic mothers. These observations lead us to speculate that alterations in the pituitary-thyroid function result in beneficial adaptations to the hostile intrauterine environment in malnutrition related growth retardation and anemia.

References

  • 1 Chan S, Kilby M D. Thyroid hormone and central nervous system development.  J Endocrinol. 2000;  165 1-8
  • 2 Robinson J S, Kingston E J, Thorburn G D. Physiological and endocrine factors in human fetal growth.  Postgrad Med. 1978;  J 54 Suppl 1 51-61
  • 3 Fisher D A. Intrauterine growth retardation: endocrine and receptor aspects.  Semin Perinatol. 1984;  8 37-41
  • 4 Gluckman P D. Harding JE. The physiology and pathophysiology of intrauterine growth retardation.  Hormone Research. 1997;  48 11-16
  • 5 Greenwood P L, Bell A W. Consequences of intra-uterine growth retardation for postnatal growth, metabolism and pathophysiology.  Reprod Suppl. 2003;  61 195-206
  • 6 Nieto-Diaz A, Villar J, Matorras-Weinig R, Valenzuela-Ruiz P. Intrauterine growth retardation at term: association between anthropometric and endocrine parameters.  Acta Obstet Gynecol Scand. 1996;  75 127-131
  • 7 Fowden A L. Endocrine regulation of fetal growth.  Reprod Fertil Dev. 1995;  7 351-363
  • 8 Barker D JP, Gluckman P D, Godfrey K M, Harding J E, Owens J A, Robinson J S. Fetal nutrition and cardiovascular disease in adult life.  Lancet. 1993;  341 938-941
  • 9 Léger J, Jaquet D, Lévy-Marchal C, Czernichow P. Syndrome X: a consequence of intra-utering malnutrition?.  Journal of Pediatric Endocrinology & Metabolism. 2000;  13 1257-1259
  • 10 De Onis M, Blossner M, Villar J. Levels and patterns of intrauterine growth retardation in developing countries.  European Journal of Clinical Nutrition. 1998;  52 5-15
  • 11 Ramachandran P. Maternal nutrition - effect on fetal growth and outcome of pregnancy.  Nutr Rev. 2002;  60 S26-34
  • 12 Vir S. Women’s nutrition - convergence of programmes - a critical issue.  Indian J Matern Child Health. 1990;  1 74-77
  • 13 Kilby M D, Verhaeg J, Gittoes N, Somerset D A, Clark P M, Franklyn J A. Circulating thyroid hormone concentrations and placental thyroid hormone receptor expression in normal human pregnancy and pregnancy complicated by intrauterine growth restriction (IUGR).  J Clin Endocrinol Metab. 1998;  83 2964-2971
  • 14 Katricheva L V, Koroliuk I P, Mironov N V. The hypophyseo-thyroid system in newborn infants with fetal growth retardation and in their mothers.  Pediatriia. 1984;  12 17-19
  • 15 Thorpe-Beeston J G, Nicolaides K H, Snijders R J, Felton C V, Vyas S, Campbell S. Relations between the fetal circulation and pituitary-thyroid function.  Br J Obstet Gynaecol. 1991;  98 1163-1167
  • 16 Thorpe-Beeston J G, Nicolaides K H. Fetal thyroid function.  Fetal Diagn Ther. 1993;  8 60-72
  • 17 Martin C R, Van Marter L J, Allred E N, Leviton A. Growth-restricted premature infants are at increased risk for low thyroxin.  Early Hum Dev. 2001;  64 119-128
  • 18 Roti E, Gnudi A, Braverman L E. The placental transport, synthesis and metabolism of hormones and drugs which affect thyroid function.  Endocr Rev. 1983;  4 131-149
  • 19 Roti E. Regulation of thyroid-stimulating hormone (TSH) secretion in the fetus and neonate.  Endocrinol Invest. 1988;  11 145-158
  • 20 Hopkins P S, Thorburn G D. The effects of foetal thyroidectomy on the development of the ovine foetus.  J Endocrinol. 1972;  54 55-66
  • 21 Chan S, Kachilele S, Hobbs E, Bulmer J N, Boelaert K, McCabe C J, Driver P M, Bradwell A R, Kester M, Visser T J, Franklyn J A, Kilby M D. Placental iodothyronine deiodinase expression in normal and growth-restricted human pregnancies.  J Clin Endocrinol Metab. 2003;  88 4488-4495
  • 22 Chopra I J, Van Herle A J, Teco G N, Nguyen A H. Serum free thyroxin in thyroidal and nonthyroidal illnesses: a comparison of measurements by radioimmunoassay, equilibrium dialysis, and free thyroxin index.  J Clin Endocrinol Metab. 1980;  51 135-143
  • 23 Roti E, Fang S L, Green K, Braverman L E, Emerson C H. Inner ring deiodination of thyroxin and 3,5,3'-triiodothyronine by human fetal membranes.  Am J Obstet Gynecol. 1983;  147 788-792
  • 24 Young R A, Rajatanavin R, Moring A F, Braverman L E. Fasting induces the generation of serum thyronine-binding globulin in Zucker rats.  Endocrinology.. 1985;  116 1248-1252
  • 25 Roth G S, Handy A M, Mattison J A, Tilmont E M, Ingram D K, Lane M A. Effects of dietary caloric restriction and aging on thyroid hormones of rhesus monkeys.  Horm Metab Res . 2002;  34 378-382
  • 26 Passos M C, da Fonte Ramos C, Dutra S C, Mouco T, de Moura E G. Long-term effects of malnutrition during lactation on the thyroid function of offspring.  Horm Metab Res. 2002;  34 40-43
  • 27 Wrutniak C, Veyre A, Cabello G. Unusual features of neonatal thyroid function in small-for-gestational-age lambs. Origin of plasma T4 and T3 deficiencies.  J Dev Physiol. 1990;  14 7-15

Supriya D. Mahajan, Ph. D.,

Department of Medicine, Div. of Allergy, Immunology, and Rheumatology

310 Multi Research Bldg. · Buffalo General Hospital · 100 High Street · Buffalo · NY 14203 · USA·

Phone: +1 (716) 859-2994

Fax: +1 (716) 859-2999

Email: smahajan@buffalo.edu

    >