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Gastrointestinal malformations in two infants born to women with hyperthyroidism untreated in the first trimester
Muhieddine Seoud1, Anwar Nassar, Ihab Usta
1Obstetrics and Gynecology, The American University of Beirut Medical Center, New York, New York 10022, USA.
Insights
Maternal hyperthyroidism during pregnancy may be linked to infant gastrointestinal anomalies, not the medication methimazole. Further research is needed to determine the teratogenic cause in these cases.
Area of Science:
- Endocrinology
- Neonatalogy
- Teratology
Background:
- Maternal hyperthyroidism is a condition requiring treatment during pregnancy.
- Methimazole is a common medication used to manage hyperthyroidism.
- The safety of antithyroid medications during pregnancy is a significant concern.
Observation:
- Two infants born to mothers with hyperthyroidism treated with methimazole after 14 weeks' gestation presented with gastrointestinal anomalies.
- One infant had esophageal atresia and tracheo-esophageal fistula.
- The other infant had biliary tree atresia.
Findings:
- Both infants achieved euthyroid status postnatally.
- The study questions whether untreated maternal hyperthyroidism or methimazole is the teratogenic agent responsible for the observed anomalies.
- This suggests a potential link between hyperthyroid state and congenital gastrointestinal defects.
Implications:
- These findings necessitate further investigation into the teratogenic potential of untreated maternal hyperthyroidism versus its treatment during pregnancy.
- Clinical management of hyperthyroid pregnant patients may need re-evaluation.
- Understanding the etiology of these congenital anomalies is crucial for improved prenatal counseling and infant care.
Abstract:
We report two infants with gastrointestinal anomalies: one with esophageal atresia and tracheo-esophageal fistula and the other with biliary tree atresia, born to hyperthyroid women diagnosed and treated with methimazole after 14 weeks' gestation. Euthyroidism was documented in both infants. These cases raise the issue of whether untreated hyperthyroidism and not methimazole intake is the teratogen.