Establishment of reference intervals of thyroid function tests from cord blood of neonates in two selected hospitals, Addis Ababa, Ethiopia

Mehari, Aman; Challa, Feyssa; Gebreyesus, Goitom; Alemayehu, Dereje; Seifu, Daniel

doi:10.1186/s12887-016-0654-2

Cited by 13 publications

(11 citation statements)

References 13 publications

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“…The values considered as reference ranges of thyroid function tests from cord blood were selected from a paper by Mehari A et al; they were determined by the same technique, but with Cobas analyzer. 17 Mothers and offspring were classified as euthyroid, hypothyroid or hyperthyroid based on TSH values, if they were in, above or under the reference ranges, respectively.…”

Section: Laboratory Evaluationmentioning

confidence: 99%

Neonates Born to Mothers with Graves’ Disease: 15 Year Experience of a Pediatric Endocrinology Department

Luz¹,

Martins²,

Jerónimo³

et al. 2020

Acta Med Port

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Introduction: Graves disease is characterized by the existence of autoantibodies directed to the thyrotropin receptor, which can have a stimulatory/inhibitory action, in women with the condition, their fetus or neonate. Our aim was to review the case series of these neonates in order to establish neonatal thyroid function predictors.Material and Methods: Retrospective cohort study of the database of the Department of Pediatric Endocrinology, including patients born to mothers with Graves’ disease, between 2002 and 2017. Clinical and biochemical data were collected from mothers and offspring.Results: Fifty newborns, from 46 women with a median of 3.5 years after diagnosis, were included. During all trimesters of pregnancy, more than half of women had positive autoantibodies directed to the thyrotropin receptor. Not every woman had a complete thyroid function evaluation every trimester. In 32 newborns, cord blood screening was done. During the neonatal period, there were three cases of hypothyroidism and two of hyperthyroidism. The mothers of these five newborns had higher levels of free thyroid hormones during the second trimester (p = 0.03). The level of antibodies directed to the thyrotropin receptor was significantly higher in the cord blood (p = 0.03) and in the first neonatal test (p = 0.03) of these dysthyroid newborns.Discussion: Our results reinforce the need for every pregnant woman with Graves’ disease to be subject to thyroid function and autoantibodies evaluation during every trimester, as well as the importance of evaluating these antibodies in cord blood.Conclusion: High levels of free thyroid hormones during the second trimester of pregnancy and antibodies directed to the thyrotropin receptor value in cord blood are predictors of dysthyroidism in neonates born from women with Grave’s disease.

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Section: Laboratory Evaluationmentioning

confidence: 99%

Neonates Born to Mothers with Graves’ Disease: 15 Year Experience of a Pediatric Endocrinology Department

Luz¹,

Martins²,

Jerónimo³

et al. 2020

Acta Med Port

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“…Cord blood sampling is convenient and non-invasive. Some studies have provided the reference values for thyroid hormones in cord blood (13)(14)(15)(16). Data on thyroid hormones in cord blood are sparse in China.…”

Section: Introductionmentioning

confidence: 99%

Advanced Maternal Age, Mode of Delivery, and Thyroid Hormone Levels in Chinese Newborns

et al. 2020

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Objective: Thyroid hormones are essential for fetal growth and neurodevelopment, however, data on cord blood thyroid hormones are sparse in China where maternal age at childbearing is increasing in recent decades. We aimed to assess cord blood levels of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) in full-term Chinese newborns, and examine potential related perinatal factors. Methods: This study included 922 mother-newborn pairs from a prospective birth cohort enrolled in 2012-2013, Shanghai, China. Cord serum concentrations of FT3, FT4, TSH, and TPOAb were measured in newborns. Results: Newborns born via cesarean section had higher cord serum FT3 (mean ± SD: 1.90 ± 1.16 pmol/L) and lower cord serum TSH (5.15 ± 2.60 mIU/L) than those born via vaginal delivery (FT3: 1.62 ± 0.93 pmol/L; TSH: 9.27 ± 6.76 mIU/L). In cesarean section deliveries, the concentration of cord serum FT3 was 0.15 (95%CI: −0.03, 0.33; p = 0.10) pmol/L lower in infants of mothers aged 30-34 years, and 0.57 (95%CI: 0.22, 0.92; p = 0.002) pmol/L lower in infants of mothers ≥35 years compared to infants of mothers <30 years. Large-for-gestational-age (birth weight >90th percentile) was associated with higher TSH (p = 0.02). Similar results were also found in vaginal deliveries. Conclusions: In this Chinese term birth cohort, newborns born via cesarean section had higher cord serum FT3 and lower TSH than those born via vaginal delivery. Advanced maternal age was associated with lower fetal FT3. Further research is needed to understand whether this association may mediate the adverse impact of advanced maternal age on neurodevelopment in early life.

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“…Thus, our findings may not apply to other periods during pregnancy. Third, reference intervals of thyroid function tests from the umbilical cord blood were not established in our hospital, although the reference ranges for umbilical cord serum have been reported to be affected by several factors including lifestyle and other environmental factors for every population in different regions even within a country [26]. Last, the possible discrepancy of ATD dosage between the medical record and actual consumption cannot be excluded because patient medication compliance was not monitored.…”

Section: Discussionmentioning

confidence: 98%

Dose-Dependent Influence of Antithyroid Drugs on the Difference in Free Thyroxine Levels between Mothers with Graves’ Hyperthyroidism and Their Neonates

et al. 2020

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Background: Several guidelines have recommended that the use of the lowest effective dose of antithyroid drugs (ATDs) that maintains maternal serum free thyroxine (FT4) levels at or moderately above the upper limit of the reference range is appropriate for fetal euthyroid status. However, little is known about whether ATD dosage affects the difference in serum FT4 levels between the mother and neonate. We conducted a retrospective study at a tertiary hospital in Japan to investigate the dose-dependent influence of ATDs on both maternal and fetal thyroid hormone status. Materials and Methods: We retrospectively examined 62 pregnant women who delivered between 2007 and 2016 and were treated for Graves’ hyperthyroidism with ATD at any stage during pregnancy. We selected individuals whose data on maternal FT4 level within 4 weeks of their deliveries and cord FT4 level of their infants at the time of delivery were available. Those with multiple pregnancies, iodine or glucocorticoid treatment, and fetal goiter detected by ultrasonography were excluded. Results: After the exclusion criteria were applied, we recruited 40 individuals. The cord FT4 levels were significantly lower than the maternal FT4 levels in patients treated with high-dosage ATDs (methimazole >5 mg daily or propylthiouracil >100 mg daily). However, there were no significant differences between maternal and cord FT4 levels in patients treated with low-dosage ATDs (methimazole ≤5 mg daily or propylthiouracil ≤100 mg daily). We selected 35 individuals whose data on maternal thyrotropin receptor-binding inhibitory immunoglobulin (TBII) level were available. Multiple linear regression analysis adjusted for ATD dosage, maternal TBII level, and gestational period found that ATD dosage was a significant predictor of the difference in serum FT4 levels between the mother and neonate. In terms of maternal complications, multiple logistic regression analysis identified maternal free triiodothyronine (FT3) level as a significant predictor of the incidence of preterm delivery. Conclusions: We found a dose-dependent influence of ATDs on the difference in serum FT4 levels between mothers with Graves’ hyperthyroidism and their neonates. Further studies to evaluate the optimal target FT4 and FT3 levels for the mother and neonate during pregnancy may improve the outcome of pregnant women with Graves’ hyperthyroidism.

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Establishment of reference intervals of thyroid function tests from cord blood of neonates in two selected hospitals, Addis Ababa, Ethiopia

Cited by 13 publications

References 13 publications

Neonates Born to Mothers with Graves’ Disease: 15 Year Experience of a Pediatric Endocrinology Department

Neonates Born to Mothers with Graves’ Disease: 15 Year Experience of a Pediatric Endocrinology Department

Advanced Maternal Age, Mode of Delivery, and Thyroid Hormone Levels in Chinese Newborns

Dose-Dependent Influence of Antithyroid Drugs on the Difference in Free Thyroxine Levels between Mothers with Graves’ Hyperthyroidism and Their Neonates

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