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[Characterization of children born to mothers with Graves' disease]
Tomás Muñoz Pérez1, María Fernanda Peña Manubens2, Rossana Román Reyes1
1Universidad de Chile, Santiago, Chile.
Insights
Neonatal hyperthyroidism in infants of mothers with Graves' disease can be predicted by maternal and neonatal thyroid-stimulating hormone receptor antibodies (TRAbs) and TSH levels. Early detection aids in managing this transient condition.
Area of Science:
- Neonatalogy
- Endocrinology
- Immunology
Background:
- Neonatal hyperthyroidism poses risks of mortality and long-term sequelae.
- Limited data exists on the local prevalence and characteristics of this condition.
Purpose of the Study:
- To characterize neonates born to mothers with Graves' disease (GD).
- To identify clinical and biochemical predictors of neonatal hyperthyroidism.
Main Methods:
- Prospective follow-up of 76 mother-child pairs over 5 years in Santiago.
- Analysis of clinical data and thyroid-stimulating hormone receptor antibodies (TRAbs) levels.
- Correlation of maternal/neonatal TRAbs and TSH with hyperthyroidism development.
Main Results:
- Five neonates (6.6%) had biochemical hyperthyroidism; 3 required treatment.
- All affected neonates had mothers with positive or indeterminate TRAbs.
- Maternal TRAbs, neonatal TRAbs, and neonatal TSH (days 2-6) correlated significantly with hyperthyroidism.
Conclusions:
- This is the first national case series on infants of mothers with GD.
- Maternal/neonatal TRAbs and early neonatal TSH are predictors of neonatal hyperthyroidism.
- All identified cases of neonatal hyperthyroidism were transient, with no mortality.
Introduction:
Neonatal hyperthyroidism is a disease that can cause mortality and sequelae. To date, there is no clinical series of cases that allows us to know the local reality of this condition.
Objective:
to charac terize the children of mothers with Graves' disease (GD) from a clinical and biochemical point of view.
Subjects And Method:
A prospective follow-up of all newborns (NB) of mothers with history of GD was performed in two public hospitals in Santiago, during 5 years. Clinical and laboratory variables of mother-child pairs and thyroid-stimulating hormone receptor antibodies (TRAbs) le vels were analyzed looking for associations between these variables and the development of neonatal hyperthyroidism.
Results:
Seventy-six mother-child pairs were included (0.2% of all deliveries). Five neonates (6.6%) presented biochemical hyperthyroidism, and 3 of them developed clinical disease and required treatment. All 5 NBs who developed hyperthyroidism had mothers with positive or indeterminate TRAbs. No child of TRAbs-negative mothers developed the disease. TRAbs could be determined in only 65% of the mothers and 72% of the NBs. There was a significant correlation bet ween maternal TRAbs titers (p < 0.03), neonatal TRAbs titers (p < 0.008), and neonatal TSH between days 2-6 (p < 0.006), with the subsequent development of hyperthyroidism. All cases of neonatal hyperthyroidism were transient. There was no mortality in our series.
Conclusions:
This is the first national case series of children of mothers with GD. Maternal and neonatal TRAbs and TSH between days 2-6 of life were predictors of neonatal hyperthyroidism.
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