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

Area of Science:

• Endocrinology
• Neonatal Health
• 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 the link between maternal thyroid factors and neonatal outcomes 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 this association.

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.
• Neonatal thyroid function and 24-month neurodevelopmental screening were assessed; logistic regression and mediation analysis were used.

Main Results:

• Maternal third-trimester TRAbs were linked to neonatal thyroid dysfunction (OR=1.59).
• Higher maternal TRAbs (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 TRAbs and neurodevelopmental outcomes.

Conclusions:

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