Objective To determine if first trimester maternal thyroid dysfunction is a critical determinant of child scholastic performance and overall educational attainment.
Design Prospective cohort study.
Setting Avon Longitudinal Study of Parents and Children cohort in the UK.
Participants 4615 mother-child pairs with an available first trimester sample (median 10 weeks gestation, interquartile range 8-12).
Exposures Free thyroxine, thyroid stimulating hormone, and thyroid peroxidase antibodies assessed as continuous measures and the seven clinical categories of maternal thyroid function.
Main outcome measures Five age-specific national curriculum assessments in 3580 children at entry stage assessment at 54 months, increasing up to 4461 children at their final school assessment at age 15.
Results No strong evidence of clinically meaningful associations of first trimester free thyroxine and thyroid stimulating hormone levels with entry stage assessment score or Standard Assessment Test scores at any of the key stages was found. Associations of maternal free thyroxine or thyroid stimulating hormone with the total number of General Certificates of Secondary Education (GCSEs) passed (range 0-16) were all close to the null: free thyroxine, rate ratio per pmol/L 1.00 (95% confidence interval 1.00 to 1.01); and thyroid stimulating hormone, rate ratio 0.98 (0.94 to 1.02). No important relationship was observed when more detailed capped scores of GCSEs allowing for both the number and grade of pass or when language, mathematics, and science performance were examined individually or when all educational assessments undertaken by an individual from school entry to leaving were considered. 200 (4.3%) mothers were newly identified as having hypothyroidism or subclinical hypothyroidism and 97 (2.1%) subclinical hyperthyroidism or hyperthyroidism. Children of mothers with thyroid dysfunction attained an equivalent number of GCSEs and equivalent grades as children of mothers with euthyroidism.
Conclusions Maternal thyroid dysfunction in early pregnancy does not have a clinically important association with impaired child performance at school or educational achievement.

中文翻译：

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孕妇甲状腺功能和儿童受教育程度：前瞻性队列研究

目的确定孕早期孕妇的甲状腺功能障碍是否是决定儿童学业成绩和整体教育水平的关键因素。
设计前瞻性队列研究。
设置父母和子女的雅芳纵向研究在英国队列。
参加者4615母子配对有可用的早孕样本（妊娠中位10周，四分位间距为8-12）。
暴露评估甲状腺激素，甲状腺刺激激素和甲状腺过氧化物酶抗体为连续性措施以及孕妇甲状腺功能的七个临床类别。
主要观察指标在3580个孩子入门阶段的评估在54个月五特定年龄的国家课程的评估，他们最终学校评估提高到4461名儿童在15岁
结果在任何关键阶段，均未发现妊娠早期甲状腺素和甲状腺刺激激素水平与进入阶段评估得分或标准评估测试得分相关的临床意义的有力证据。孕产妇游离甲状腺素或甲状腺刺激激素与通过的普通中等教育证书总数（GCSE）的关联（范围为0-16）都接近零：游离甲状腺素，每pmol / L的比率1.00（95％置信度）区间1.00至1.01）；和甲状腺刺激激素，比率为0.98（0.94至1.02）。当更详细的GCSE封顶分数允许通过的数量和等级，或者语言，数学，单独或在考虑个人从入学到离校期间进行的所有教育评估时，都要检查科学和科学表现。新发现200名（4.3％）母亲患有甲状腺功能减退症或亚临床甲状腺功能减退症，另有97名（2.1％）母亲患有亚临床甲状腺功能亢进症或甲状腺功能亢进症。甲状腺功能障碍的母亲的孩子与甲状腺功能正常的母亲的孩子获得的GCSE数量和等级相同。
结论妊娠早期的孕妇甲状腺功能异常与在学或学业成绩不佳的儿童上没有临床上的重要联系。