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Thyroid function in infants born to women with hypothyroidism: An observational study at an Australian tertiary

Darazel B Perez1, Pranav Jani1,2, Rajesh Maheshwari1,2

  • 1Department of Neonatology, Westmead Hospital, Sydney, Australia.

Clinical Endocrinology
|January 8, 2023
PubMed

Insights

Routine thyroid function tests for infants born to mothers with hypothyroidism are unnecessary. Most infants have normal thyroid function, and additional testing offers no benefit beyond standard newborn screening.

Area of Science:

  • Neonatal care
  • Endocrinology
  • Maternal-fetal medicine

Background:

  • Maternal hypothyroidism, including autoimmune forms, raises concerns about infant thyroid dysfunction.
  • Thyroid function testing is often performed in early infancy due to these concerns.

Purpose of the Study:

  • To evaluate the effectiveness of routine thyroid function testing at two weeks of age in healthy, full-term infants born to mothers with hypothyroidism.
  • To identify thyroid dysfunction in this specific infant population.

Main Methods:

  • Retrospective, observational, single-center study.
  • Included full-term infants (≥37 weeks gestation) born to mothers with hypothyroidism (excluding Graves' disease or prior thyroidectomy).
  • Analyzed thyroid function tests performed around two weeks of age.

Main Results:

  • 99% of 780 infants had normal thyroid function.
  • Only 1% (10 infants) had elevated thyroid-stimulating hormone (TSH) levels (>10 mIU/L), with 9 normalizing within two weeks.
  • One infant was diagnosed with congenital hypothyroidism via routine newborn screening.
  • No infants born to mothers with known anti-thyroid antibodies had elevated TSH levels.

Conclusions:

  • Infants born to mothers with hypothyroidism generally exhibit normal thyroid function in the early neonatal period.
  • Elevated TSH levels in a small subset of infants typically normalize by four weeks of age.
  • Routine thyroid function testing in this cohort provides no additional benefit beyond standard newborn screening.
Abstract

Keywords:
autoimmune hypothyroidismmaternal hypothyroidismnewborn infantthyroid function

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