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Blog
Maternal Depression and Hypothyroidism Linked to Infant Gastroschisis
A Canadian Cohort Study
Claude Hughes, M.D., Ph.D.
Feb 14, 2024

In a recent Scientific Reports article titled, “Association of maternal depression and hypothyroidism with infant gastroschisis: a population‑based cohort study in Canada,” the international team led by Dr. Shiliang Liu of the Public Health Agency of Canada with collaborators from the U.S., Malaysia and China, discussed a pioneering population-based cohort study conducted in Canada, where researchers have discovered a significant association between maternal depression and hypothyroidism and an increased risk of infant gastroschisis. The study analyzed data from infants born in Canada from 2004 to 2020.

Gastroschisis, a serious defect where the baby's intestines are outside of the body, has seen a global increase in recent decades. This increase remains unexplained by existing risk factors. The study sought to fill this gap, and the findings could have major implications for understanding the underlying causes and potential prevention strategies.

The researchers used "winter" months and northern areas of residence as indicators of less sunlight and less active lifestyles. They found that infants conceived in winter had a higher rate of gastroschisis (3.4 per 10,000) than those conceived in summer (2.2 per 10,000). The study identified exposure to winter, northern area, hypothyroidism, substance use, tobacco use, and depressive disorders as potential risk factors for gastroschisis.

The study revealed a significant interaction between women under 24 years of age and 2-month conception intervals. Furthermore, the association of maternal depression with infant gastroschisis was mediated by hypothyroidism. In contrast, substance use, hypothyroidism, tobacco smoking, and gestational diabetes showed 5.5-, 3.1-, 2.7-, and 1.2-fold associations, respectively, with maternal depression.

Importantly, the study found that an increased risk of gastroschisis spanned the ten months outside the summer conception interval. This risk was associated with higher levels of stress adaptation, thermoregulation and metabolism, reproduction, and growth effector hormones.

The findings suggest that periconception depression, mediated by hypothyroidism, may play a causal role in offspring gastroschisis. Researchers also found that maternal hypothyroidism could be a key causal factor in the occurrence of many cases of gastroschisis.

The strengths of the study include the use of data from a vast geographical area with differential latitudes and distinctive seasonal variation. However, the study also has several limitations. For instance, some risk factors associated with gastroschisis may be tested after the occurrence of a congenital anomaly or other adverse pregnancy outcomes.

Read the full article here.

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