Maternal Third-Trimester TRAb Is Associated with Neonatal Thyroid Dysfunction and 24-Month Offspring...

Area of Science:

• Endocrinology
• Neonatal care
• Developmental pediatrics

Background:

• Maternal Graves' disease (GD) is associated with neonatal thyroid dysfunction.
• The impact of maternal GD on offspring neurodevelopment is not well understood.
• Investigating maternal thyroid factors and their effects on neonatal thyroid function and neurodevelopment is crucial.

Purpose of the Study:

• To examine the associations between maternal GD-related thyroid factors and neonatal thyroid function.
• To assess the relationship between maternal GD and offspring neurodevelopment at 24 months.
• To explore the potential mediating role of neonatal thyroid function in the association between maternal GD and offspring neurodevelopment.

Main Methods:

• A single-center bidirectional cohort study included pregnant women with GD and their offspring.
• Maternal thyroid variables (TSH, free T4, TRAbs) and antithyroid drug exposure were collected during pregnancy.
• Neonatal thyroid function and offspring neurodevelopment (Ages and Stages Questionnaire, Third Edition) were assessed post-birth and at 24 months, respectively.

Main Results:

• Maternal third-trimester thyrotropin receptor antibodies (TRAbs) were linked to neonatal thyroid dysfunction (OR = 1.59).
• Higher maternal third-trimester TRAb (OR = 1.15) and neonatal TSH (OR = 1.11) were associated with abnormal neurodevelopmental screening at 24 months.
• Neonatal TSH did not significantly mediate the association between maternal TRAb and neurodevelopmental outcomes.

Conclusions:

• Elevated maternal third-trimester TRAb levels in Graves' disease are associated with both neonatal thyroid dysfunction and abnormal neurodevelopmental screening in offspring.
• The observed association between maternal TRAb and offspring neurodevelopment is not primarily explained by neonatal thyroid function alone.
• Further research is needed to elucidate the mechanisms linking maternal GD to offspring neurodevelopmental outcomes.