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[Maternal autoimmune thyroid disease: relevance for the newborn]
M Carmen Temboury Molina1, M José Rivero Martín2, Jesús de Juan Ruiz3
1Servicio de Pediatría, Hospital del Sureste, Arganda del Rey, Madrid, España.
Medicina Clinica
|February 4, 2014
Summary
Maternal autoimmune thyroid disease can affect newborns, causing thyroid dysfunction and requiring thyroxine treatment in some cases. Early screening and follow-up of infant thyroid function are crucial for proper management.
Area of Science:
- Endocrinology
- Neonatology
- Immunology
Context:
- Autoimmune thyroid disease (AITD) is a common endocrine disorder during pregnancy.
- Maternal AITD is linked to adverse perinatal outcomes, including fetal and neonatal thyroid dysfunction.
- Maternal thyroid hormones are vital for fetal neurodevelopment.
Purpose:
- To evaluate the thyroid function and clinical course of neonates born to mothers with AITD.
- To establish appropriate follow-up guidelines for these infants.
Summary:
- 81 newborns of mothers with AITD (Graves' disease or autoimmune thyroiditis) were monitored.
- 4.93% had congenital defects; 8.64% required thyroxine for elevated TSH. Higher TSH correlated with maternal age, TPO antibodies, and lower birth weight.
- Higher FT4 was associated with younger infant age and maternal Graves' disease.
Impact:
- Recommends pre-conception/early pregnancy screening for TSH, T4, and TPO antibodies in pregnant women.
- Suggests neonatal screening at 48 hours and repeat testing between 2-4 weeks for infants with TSH > 6 μUI/mL.
- Emphasizes careful endocrine follow-up for pregnant women and infants with detected thyroid abnormalities.
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