Maternal Thyroid Hormone Imbalance and Risk of Autism Spectrum Disorder
Authors' conclusion
The findings suggest adequately treated chronic hypothyroidism is not associated with ASD in offspring, whereas persistent hormonal imbalance across trimesters conveys elevated risk. These findings underscore the importance of routine thyroid function screening and timely treatment throughout pregnancy.
Study context
- Population
- Singleton births, January 2011–December 2017, Soroka University Medical Center, southern Israel; follow-up through January 2021
- Participants
- 51,296 singleton births
- Exposure
- Maternal thyroid dysfunction vs normal thyroid function
- Abnormal thyroid functionn = 4,409
- Outcome
- Offspring ASD diagnosis (Diagnostic and Statistical Manual of Mental Disorders, fifth edition)
- Follow-up
- Through January 2021
Methodological detailssingle tertiary hospital, linked to Clalit Health Services electronic records
- Single tertiary hospital
- Linked to Clalit Health Services electronic records
Main finding
As reported in the abstract
ASD cumulative incidence in offspring
- Autism spectrum disorder (ASD) cumulative incidence similar with normal and abnormal maternal thyroid function
- Abnormal thyroid function vs Normal thyroid function: log-rank P = .27
Observational data: associations, not effects.
Further findings
ASD risk by type of maternal hypothyroidism
- Chronic hypothyroidism only (likely adequately treated): aHR (95% CI 0.15-1.48), not significant
- 0.47
- Combined chronic and gestational hypothyroidism: aHR
- 2.61 (95% CI 1.44-4.74)
ASD risk by trimesters of hypothyroidism exposure (dose-response)
- 1 trimester: aHR
- 1.69 (95% CI 1.19-2.83)
- 2 trimesters: aHR
- 2.39 (95% CI 1.24-5.78)
- 3 trimesters: aHR
- 3.25 (95% CI 1.07-7.21)
Original publication
Maternal Thyroid Hormone Imbalance and Risk of Autism Spectrum Disorder. J Clin Endocrinol Metab. Published 25 November 2025. doi:10.
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