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Sakornyutthadej N, Mahachoklertwattana P, Poomthavorn P. Thyroid function and long-term outcomes of children born to mothers with Graves' disease: A 20-year review. J Paediatr Child Health 2023; 59:526-532. [PMID: 36722797 DOI: 10.1111/jpc.16343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/22/2022] [Accepted: 01/14/2023] [Indexed: 02/02/2023]
Abstract
AIM Thyroid dysfunction in infants born to mothers with Graves' disease (GD) is influenced by maternal factors including thyroid status, thyroid-stimulating hormone (TSH) receptor antibody (TRAb) concentration and antithyroid drug use. Thyroid dysfunction during early life could affect growth and development later in life. The aim of this study is to evaluate thyroid function tests (TFTs), and long-term growth and development of children born to mothers with GD. METHODS A retrospective chart review of children born to mothers with GD at the Faculty of Medicine Ramathibodi Hospital, Mahidol University, between January 2000 and December 2019 was performed. Clinical data including age of children at enrolment, sex, gestational age, birthweight, maternal thyroid status, maternal TRAb level, maternal GD treatment during pregnancy, neonatal TSH screening and TFT results, and growth and development outcomes of children were collected. RESULTS There were 262 children (148 males) enrolled. Twelve (4%) infants had neonatal GD. Five (2%) infants had hypothyroidism requiring levothyroxine treatment: four had secondary hypothyroidism and one patient had congenital primary hypothyroidism. Seven (3%) infants had transient TSH elevation, which fell to normal by 2 weeks of age. The remaining 238 children had normal TFT results. Three out of 12 children with neonatal GD had either delayed growth or development. CONCLUSIONS A number of infants born to mothers with GD had abnormal TFTs requiring specific management, and some of them had abnormal growth and development. Careful evaluation of TFTs and long-term follow-up are mandatory for those children.
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Affiliation(s)
- Natee Sakornyutthadej
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pat Mahachoklertwattana
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Preamrudee Poomthavorn
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Ishikawa T, Uchiyama H, Iwashima S, Baba T, Ohishi A, Iijima S, Itoh H. Hemodynamic changes in neonates born to mothers with Graves' disease. Endocrine 2021; 72:171-178. [PMID: 32785898 DOI: 10.1007/s12020-020-02443-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 07/28/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Cardiac insufficiency is a major morbidity in neonatal hyperthyroidism. It is important to assess the hemodynamics in neonates born to mothers with Graves' disease (GD). This study prospectively evaluated the hemodynamic changes in neonates born to mothers with GD. METHODS Overall, 80 newborns were enrolled. Thirty-six neonates were born to mothers with GD who were positive for thyroid-stimulating hormone (TSH) receptor antibody (TRAb), and 44 were born to mother negative for TRAb. The serum levels of TSH, free triiodothyronine (FT3), free thyroxine (FT4), and N-terminal-pro-B-type natriuretic peptide (NT-proBNP), the cardiac output, and cardiac index (CI) evaluated by echocardiography were compared between the two groups at several postnatal points (day of delivery and 5, 10, and 30 days of life). RESULTS The TRAb-positive newborns had higher FT4 levels and CI on Day 5 (both p < 0.05) and higher FT3 (p < 0.05) and FT4 levels (p < 0.01) and CI (p < 0.01) but lower TSH levels (p < 0.05) on Day 10 than the TRAb-negative newborns. The TRAb-positive newborns had significantly higher NT-proBNP levels on Days 5 (median 752 vs. 563 pg/mL, p = 0.034) and 10 (median 789 vs. 552 pg/mL, p = 0.002) than the TRAb-negative newborns. CONCLUSIONS Hemodynamic changes in neonates born to TRAb-positive mothers with GD resulted in a higher CI and NT-proBNP levels than in those with TRAb-negative mothers from postnatal days 5 to 10.
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Affiliation(s)
- Takamichi Ishikawa
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan.
| | - Hiroki Uchiyama
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Satoru Iwashima
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Toru Baba
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Akira Ohishi
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Shigeo Iijima
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Hiroaki Itoh
- Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Shizuoka, Japan
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De Rose DU, Iannotta R, Gallini F, Maggio L, Zecca E, Catenazzi P, Vento G. Infants born to mothers with autoimmune thyroid disorders: "Why" should we always measure anti-TSH-receptor antibodies. Early Hum Dev 2019; 140:104906. [PMID: 31670176 DOI: 10.1016/j.earlhumdev.2019.104906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/14/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Domenico Umberto De Rose
- Neonatology Unit, Department of Pediatrics, Fondazione Policlinico "A. Gemelli" IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Rossella Iannotta
- Neonatology Unit, Department of Pediatrics, Fondazione Policlinico "A. Gemelli" IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesca Gallini
- Neonatology Unit, Department of Pediatrics, Fondazione Policlinico "A. Gemelli" IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Maggio
- Neonatology Unit, Department of Pediatrics, Fondazione Policlinico "A. Gemelli" IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Enrico Zecca
- Neonatology Unit, Department of Pediatrics, Fondazione Policlinico "A. Gemelli" IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Piero Catenazzi
- Neonatology Unit, Department of Pediatrics, Fondazione Policlinico "A. Gemelli" IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Vento
- Neonatology Unit, Department of Pediatrics, Fondazione Policlinico "A. Gemelli" IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
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Ares Segura S, Temboury Molina C, Chueca Guindulain MJ, Grau Bolado G, Alija Merillas MJ, Caimari Jaume M, Casano Sancho P, Moreno Navarro JC, Rial Rodríguez JM, Rodríguez Sánchez A. Recommendations for the diagnosis and followup of the foetus and newborn child born to mothers with autoimmune thyroid disease. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2018. [DOI: 10.1016/j.anpede.2018.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Ares Segura S, Temboury Molina C, Chueca Guindulain MJ, Grau Bolado G, Alija Merillas MJ, Caimari Jaume M, Casano Sancho P, Moreno Navarro JC, Rial Rodríguez JM, Rodríguez Sánchez A. [Recommendations for the diagnosis and follow up of the foetus and newborn child born to mothers with autoimmune thyroid disease]. An Pediatr (Barc) 2018; 89:254.e1-254.e7. [PMID: 30177500 DOI: 10.1016/j.anpedi.2018.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 07/17/2018] [Accepted: 07/19/2018] [Indexed: 02/08/2023] Open
Abstract
The objective of this document is to review the current recommendations in the management of the foetus and the newborn child born to mothers with autoimmune thyroid disease. In 2017, the American Thyroid Association published guidelines for the diagnosis and management of thyroid disease during pregnancy and post-partum. In this guide, 97 recommendations were made, and an algorithm for the diagnosis and treatment of gestational hypothyroidism was proposed. Also, in this last year, a wide review was been published on the foetal and neonatal approach of the child of a mother with Graves' disease. The importance of the determination of maternal antibodies against thyrotropin receptor in the second half of pregnancy is stressed, in order to adequately stratify the risk in the neonate.
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Affiliation(s)
- Susana Ares Segura
- Servicio de Neonatología, Hospital Universitario La Paz, Madrid, España.
| | | | | | - Gema Grau Bolado
- Endocrinología Infantil, Hospital Universitario Cruces, Barakaldo, Vizcaya, España
| | | | - María Caimari Jaume
- Endocrinología Pediátrica, Hospital Universitario Son Espases, Palma de Mallorca, Baleares, España
| | - Paula Casano Sancho
- Sección de Endocrinología Pediátrica, Hospital Sant Joan de Déu , Barcelona, España
| | | | | | - Amparo Rodríguez Sánchez
- Unidad de Metabolismo y Desarrollo, Hospital General Universitario Gregorio Marañón , Madrid, España
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van Dijk MM, Smits IH, Fliers E, Bisschop PH. Maternal Thyrotropin Receptor Antibody Concentration and the Risk of Fetal and Neonatal Thyrotoxicosis: A Systematic Review. Thyroid 2018; 28:257-264. [PMID: 29325496 DOI: 10.1089/thy.2017.0413] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND In pregnant women with Graves' disease, maternal thyrotropin receptor antibodies (TRAb) can cross the placenta and induce fetal or neonatal thyrotoxicosis. Symptoms of fetal thyrotoxicosis are tachycardia, intrauterine growth restriction, and intra-uterine death. Recommendations on an upper limit of TRAb concentrations below which intensive fetal monitoring can be safely omitted vary between different guidelines. The objective of this study was to define an evidence-based cutoff level for maternal TRAb necessitating additional fetal monitoring during pregnancy. METHODS A literature search was performed to identify studies on pregnant women with Graves' disease and fetal and/or neonatal thyrotoxicosis. Only studies that reported TRAb were included. RESULTS From a total of 229 identified titles, 20 articles could be included in the analysis. A total of 53 cases of fetal and/or neonatal thyrotoxicosis were described. The lowest level of maternal TRAb leading to neonatal thyrotoxicosis was 4.4 U/L, which corresponds to 3.7 times the upper limit of normal. The level of evidence for this threshold is moderate to low. CONCLUSION In women with Graves' disease, intensive fetal monitoring is recommended when maternal TRAb concentrations are >3.7 times the upper limit of normal. This cutoff level should be interpreted with caution, since evidence is limited.
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Affiliation(s)
- Myrthe M van Dijk
- 1 Center for Reproductive Medicine, Department of Obstetrics and Gynecology, University of Amsterdam , Amsterdam, The Netherlands
| | - Iris H Smits
- 2 Departments of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam , Amsterdam, The Netherlands
| | - Eric Fliers
- 2 Departments of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam , Amsterdam, The Netherlands
| | - Peter H Bisschop
- 2 Departments of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam , Amsterdam, The Netherlands
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van der Kaay DCM, Wasserman JD, Palmert MR. Management of Neonates Born to Mothers With Graves' Disease. Pediatrics 2016; 137:peds.2015-1878. [PMID: 26980880 DOI: 10.1542/peds.2015-1878] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2015] [Indexed: 11/24/2022] Open
Abstract
Neonates born to mothers with Graves' disease are at risk for significant morbidity and mortality and need to be appropriately identified and managed. Because no consensus guidelines regarding the treatment of these newborns exist, we sought to generate a literature-based management algorithm. The suggestions include the following: (1) Base initial risk assessment on maternal thyroid stimulating hormone (TSH) receptor antibodies. If levels are negative, no specific neonatal follow-up is necessary; if unavailable or positive, regard the newborn as "at risk" for the development of hyperthyroidism. (2) Determine levels of TSH-receptor antibodies in cord blood, or as soon as possible thereafter, so that newborns with negative antibodies can be discharged from follow-up. (3) Measurement of cord TSH and fT4 levels is not indicated. (4) Perform fT4 and TSH levels at day 3 to 5 of life, repeat at day 10 to 14 of life and follow clinically until 2 to 3 months of life. (5) Use the same testing schedule in neonates born to mothers with treated or untreated Graves' disease. (6) When warranted, use methimazole (MMI) as the treatment of choice; β-blockers can be added for sympathetic hyperactivity. In refractory cases, potassium iodide may be used in conjunction with MMI. The need for treatment of asymptomatic infants with biochemical hyperthyroidism is uncertain. (7) Assess the MMI-treated newborn on a weekly basis until stable, then every 1 to 2 weeks, with a decrease of MMI (and other medications) as tolerated. MMI treatment duration is most commonly 1 to 2 months. (8) Be cognizant that central or primary hypothyroidism can occur in these newborns.
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Affiliation(s)
| | - Jonathan D Wasserman
- Division of Endocrinology, The Hospital for Sick Children; and Departments of Paediatrics and
| | - Mark R Palmert
- Division of Endocrinology, The Hospital for Sick Children; and Departments of Paediatrics and Physiology, The University of Toronto, Toronto, Ontario, Canada
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Yoshioka W, Miyauchi A, Ito M, Kudo T, Tamai H, Nishihara E, Kihara M, Miya A, Amino N. Kinetic analyses of changes in serum TSH receptor antibody values after total thyroidectomy in patients with Graves' disease. Endocr J 2016; 63:179-85. [PMID: 26632172 DOI: 10.1507/endocrj.ej15-0492] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We often recommend total thyroidectomy for patients with Graves' disease who wish to have a child in the near future in order to prevent fetal or neonatal hyperthyroidism, especially if the patients' serum thyrotropin receptor antibody (TRAb) values are high. The aim of this study was to analyze changes in serum TRAb values using a quantitative third-generation assay after total thyroidectomy and the half-lives of serum TRAb values to estimate the postoperative time needed to achieve the safe TRAb value for mothers. We retrospectively examined the records of 45 Graves' disease patients who underwent a total thyroidectomy and had high serum TRAb values. We also evaluated factors that prolonged the postoperative reduction of serum TRAb values. The serum TRAb values decreased rapidly in most of the patients, especially within the early postoperative (3-month) period. The presence of Graves' ophthalmopathy (GO) (p=0.001), smoking (p=0.004), and serum thyroglobulin values > 0.5 ng/mL at postoperative 12 months (p=0.039) were significantly associated with prolonged half-lives of the serum TRAb values. The median TRAb value half-life was 93.5 days in the patients without GO or smoking, 162.5 days in the patients with GO or smoking, and 357.4 days in the patients with both GO and smoking. Our findings indicate that using the half-life of patients' serum TRAb values determined by this third-generation assay would be effective to evaluate the reduction of serum TRAb values after total thyroidectomy and to estimate the postoperative time needed to achieve the maternal safe value.
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Affiliation(s)
- Waka Yoshioka
- Departments of Internal Medicine, Kuma Hospital, Center for Excellence in Thyroid Care, Kobe 650-0011, Japan
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Besançon A, Beltrand J, Le Gac I, Luton D, Polak M. Management of neonates born to women with Graves' disease: a cohort study. Eur J Endocrinol 2014; 170:855-62. [PMID: 24670885 DOI: 10.1530/eje-13-0994] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Hyperthyroidism in neonates born to mothers with Graves' disease (GD) can be associated with significant morbidity and mortality, but is still overlooked by clinicians. Management of neonatal hyperthyroidism would be improved by a better understanding of the predictive factors involved. The aim of this study was to evaluate the course of thyroid function and clinical outcomes during the first postnatal month in babies born to mothers with GD. DESIGN Prospective observational study. METHODS Sixty-eight neonates born to mothers with GD were managed from birth and divided into three groups based on thyrotropin receptor antibody (TRAb) and anti-thyroid drug (ATD) status in the mother: TRAb(-ve)/ATD(-ve), n=27; TRAb(-ve)/ATD(+) (ve), n=8; and TRAb(+ve)/ATD(+ve), n=33. The main outcome measures were clinical examination, thyroid function tests (TSH, free thyroxine (FT4), free triiodothyronine, and TRAb), echocardiography, thyroid ultrasonography, and bone maturation assessment. RESULTS None of the infants born to TRAb(-ve) mothers with GD developed neonatal hyperthyroidism. Of the 33 TRAb(+ve)/ATD(+ve) neonates, 24 (72.7%) had positive TRAb on cord blood assays, and seven of these developed neonatal hyperthyroidism. FT4 elevation between days 3 and 7 but not at birth was predictive of the development of hyperthyroidism. CONCLUSIONS TRAb status should be checked in the third trimester in mothers with GD and on cord blood in their neonates; if positive, it indicates a high risk of neonatal hyperthyroidism. FT4 measurement at birth should be repeated between days 3 and 5 (and by day 7 at the latest); rapid FT4 elevation during the first postnatal week is predictive of hyperthyroidism and warrants ATD therapy.
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Affiliation(s)
- Alix Besançon
- Endocrinologie Gynécologie Diabétologie PédiatriquesHôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, 149 Rue de Sèvres, 75015 Paris FranceINSERM U1016IMAGINE Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDépartement de Maternité Bichat-BeaujonAssistance Publique-Hôpitaux de Paris, DHU Risque et Grossesse, Université Paris VII, Paris, France
| | - Jacques Beltrand
- Endocrinologie Gynécologie Diabétologie PédiatriquesHôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, 149 Rue de Sèvres, 75015 Paris FranceINSERM U1016IMAGINE Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDépartement de Maternité Bichat-BeaujonAssistance Publique-Hôpitaux de Paris, DHU Risque et Grossesse, Université Paris VII, Paris, FranceEndocrinologie Gynécologie Diabétologie PédiatriquesHôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, 149 Rue de Sèvres, 75015 Paris FranceINSERM U1016IMAGINE Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDépartement de Maternité Bichat-BeaujonAssistance Publique-Hôpitaux de Paris, DHU Risque et Grossesse, Université Paris VII, Paris, France
| | - Isabelle Le Gac
- Endocrinologie Gynécologie Diabétologie PédiatriquesHôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, 149 Rue de Sèvres, 75015 Paris FranceINSERM U1016IMAGINE Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDépartement de Maternité Bichat-BeaujonAssistance Publique-Hôpitaux de Paris, DHU Risque et Grossesse, Université Paris VII, Paris, France
| | - Dominique Luton
- Endocrinologie Gynécologie Diabétologie PédiatriquesHôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, 149 Rue de Sèvres, 75015 Paris FranceINSERM U1016IMAGINE Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDépartement de Maternité Bichat-BeaujonAssistance Publique-Hôpitaux de Paris, DHU Risque et Grossesse, Université Paris VII, Paris, France
| | - Michel Polak
- Endocrinologie Gynécologie Diabétologie PédiatriquesHôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, 149 Rue de Sèvres, 75015 Paris FranceINSERM U1016IMAGINE Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDépartement de Maternité Bichat-BeaujonAssistance Publique-Hôpitaux de Paris, DHU Risque et Grossesse, Université Paris VII, Paris, FranceEndocrinologie Gynécologie Diabétologie PédiatriquesHôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, 149 Rue de Sèvres, 75015 Paris FranceINSERM U1016IMAGINE Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDépartement de Maternité Bichat-BeaujonAssistance Publique-Hôpitaux de Paris, DHU Risque et Grossesse, Université Paris VII, Paris, France
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Temboury Molina MC, Rivero Martín MJ, de Juan Ruiz J, Ares Segura S. [Maternal autoimmune thyroid disease: relevance for the newborn]. Med Clin (Barc) 2014; 144:297-303. [PMID: 24486115 DOI: 10.1016/j.medcli.2013.10.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 10/26/2013] [Accepted: 10/31/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVE Autoimmune thyroid disease is amongst the most frequent endocrine disorders during pregnancy. It is associated with an increase in perinatal morbidity, congenital defects, neurological damage, fetal and neonatal thyroid dysfunction. Maternal thyroid hormones play a key role in child neurodevelopment. We aimed to evaluate the thyroid function and the clinical course of neonates born from mothers with autoimmune thyroid disease during the first months of life in order to define the follow-up. PATIENTS AND METHOD We monitored thyroid function and clinical status during the first months in 81 newborns of mothers with autoimmune thyroid disease; 16 had Graves disease and 65 autoimmune thyroiditis. RESULTS A percentage of 4.93 newborns had congenital defects, and 8.64% neonates showed an increase in thyrotropin (TSH) (>9.5 μUI/mL 2 times) and required thyroxin within the first month of life. A 85.7% of these showed a negative newborn screening (due to a later increase of TSH). A higher TSH value in the newborn was related to an older age of the mother, higher levels of thyroid peroxidase (TPO) antibody during pregnancy and lower birth weight. A higher free thyroxine (FT4) value in the newborn was related to fewer days of life and mothers with Graves disease. CONCLUSIONS We recommend the evaluation of TSH, T4 and TPO antibodies before 10 weeks in all pregnant women with follow-up if maternal thyroid autoimmunity or disorders is detected. It is also recommended to test children's serum TSH and FT4 at 48 h of life in newborns of mothers with autoimmune thyroid disease and repeat them between the 2nd and 4th week in children with TSH>6 μUI/mL. Careful endocrine follow-up is advised in pregnant women and children if hyperthyroidism is detected.
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Affiliation(s)
| | | | - Jesús de Juan Ruiz
- Cátedra de Estadística, Escuela Superior de Ingenieros Industriales de Madrid, Madrid, España
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Dierickx I, Decallonne B, Billen J, Vanhole C, Lewi L, De Catte L, Verhaeghe J. Severe fetal and neonatal hyperthyroidism years after surgical treatment of maternal Graves’ disease. J OBSTET GYNAECOL 2014; 34:117-22. [DOI: 10.3109/01443615.2013.831044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bibliography. Current world literature. Obesity and nutrition. Curr Opin Endocrinol Diabetes Obes 2008; 15:470-5. [PMID: 18769222 DOI: 10.1097/med.0b013e328311f3cb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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