Maternal autoimmune thyroid disease: Relevance for the newborn

Molina, M. Carmen Temboury; Martı́n, M. J.; Ruiz, Jesús Juan; Segura, Susana Ares

doi:10.1016/j.medcle.2013.10.002

Cited by 12 publications

(8 citation statements)

References 25 publications

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“…All infants had normal newborn screens, but many had abnormal TSH levels if checked before 6 days of life, which tended to normalize in the second week of life. 8 Temboury et al 9 looked at infants of 81 mothers with thyroid disease (either Hashimoto thyroiditis or Graves’s disease), and found that 8.64% had TSH levels >9.5 on 2 tests, and 85.7% of these had negative newborn screening results. This led to a recommendation to check TSH levels in these infants at 48 hours, and then at 2 to 4 weeks of life.…”

Section: Discussionmentioning

confidence: 99%

“…This led to a recommendation to check TSH levels in these infants at 48 hours, and then at 2 to 4 weeks of life. 9 Our cohort included 7 cases of congenital hypothyroidism out of 352 infants with known disease status. This is higher than the reported rate of congenital hypothyroidism of approximately 1:3000 in the general population (and recent data showed an incidence of congenital hypothyroidism of 1:2500).…”

Section: Discussionmentioning

confidence: 99%

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Thyroid Function Testing in Neonates With Maternal History of Disease

Underland

Kenigsberg

Derrick

et al. 2017

Clin Pediatr (Phila)

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Maternal history of thyroid disease can cause congenital hypothyroidism due to thyroid-stimulatng hormone (TSH) blocking antibodies. No guidelines exist regarding testing beyond the newborn screen. TSH and T4 levels exhibit significant fluctuations after birth which complicates testing. A total of 561 newborns with thyroid function testing done for maternal history of thyroid disease in the newborn nursery were identified retrospectively via chart review, and thyroid disease status was assessed in 352. Newborn screening data were also obtained. Of these infants, 7 had hypothyroidism with 3 having negative newborn screens. No cases of neonatal graves were identified. The 3 infants with negative newborn screens had TSH levels ranging from 6.58 to 28.4 prior to treatment with levothyroxine. All required treatment beyond age 3 years, despite trial off levothyroxine. Infants with maternal history of thyroid disease may require additional testing beyond the newborn screen. However, providers can consider delaying test until after thyroid levels are more stable.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Thyroid Function Testing in Neonates With Maternal History of Disease

Underland

Kenigsberg

Derrick

et al. 2017

Clin Pediatr (Phila)

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“…Its geography and ethnic makeup means that it is different from other areas of China. A previous study reported the incidence of CH as detected by NSP to be about 1:835 in Guangxi, 11 which is much higher than the average for the whole country. But the incidence of confirmed cases of PCH and TCH among patients and the reasons of the high incidence of CH in this area are still unclear and is yet to be fully reported.…”

Section: Introductionmentioning

confidence: 78%

Incidence and Interrelated Factors in Patients With Congenital Hypothyroidism as Detected by Newborn Screening in Guangxi, China

Fan

Chen

Qian

et al. 2015

Global Pediatric Health

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Background. A newborn screening program (NSP) for congenital hypothyroidism (CH) was carried out in Guangxi in order to understand the incidence of CH and the factors interrelated to major types of CH in this region of China. Methods. During 2009 to 2013, data from 930 612 newborns attending NSP in Guangxi were collected. Patients were classified with either permanent CH (PCH) or transient CH (TCH) after 2 years of progressive study. Results. A total of 1210 patients were confirmed with CH with an incidence of 1/769, including 68 PCH and 126 TCH cases with incidences of 1/6673 and 1/3385, respectively. The frequency of thyroid stimulating hormone values greater than 5 mIU/L was 7.2%, which, based on WHO guidelines, suggests that the population was mildly iodine deficient. Conclusions. The incidence of CH was high in Guangxi. Approximately two thirds of CH patients were TCH, which may be due to a deficiency in iodine within the population.

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“…These maternal comorbidities may lead to congenital malformation. Some medical conditions pose teratogenic risks including gestational diabetes ( Allen et al, 2007 , Ornoy et al, 2015 ) and thyroid diseases ( Temboury Molina et al, 2015 ) which were found to be associated with high risks of congenital malformations and other fetal complications. Likewise, other medication use during pregnancy could induce birth defects and other fetal complications.…”

Section: Discussionmentioning

confidence: 99%

Antiseizure medications use during pregnancy and congenital malformations: A retrospective study in Saudi Arabia

Alsfouk

Almarzouqi

Alsfouk

et al. 2021

Saudi Pharmaceutical Journal

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Aim To evaluate the incidence of congenital malformations in children exposed prenatally to antiseizure medications (ASMs), to assess other perinatal and fetal complications, and to determine the potential predictors for these complications. Method A retrospective review of pregnancy outcomes of women with epilepsy. Patients were followed up at the King Faisal Specialist Hospital and Research Centre, Riyadh and Jeddah, Saudi Arabia, between Dec 1993 and Oct 2020. Results Of 162 pregnancies included, 10 (6.17%) congenital malformations were observed, 6.82% in ASM-exposed babies versus 3.33% in babies of epilepsy-untreated mothers (P = 0.69). The overall incidence of perinatal and fetal complications was 53%; most frequent were low birth weight (24%), preterm birth (19%), transfer to neonatal intensive care unit (18%) and abortion (8%). These complications were higher in the untreated group (66.67%) than in the ASM group (50%). The use of other non-antiseizure medications during pregnancy was the only factor that significantly increased the risk of complications. Conclusion Prenatal exposure to ASMs was associated with increased risk of congenital malformations. However, overall perinatal and fetal complications were higher in the untreated group than in the ASM group, which could be explained by maternal seizures. Therefore, taking ASMs to control epilepsy and prevent perinatal complications may outweigh the risks of teratogenicity.

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Maternal autoimmune thyroid disease: Relevance for the newborn

Cited by 12 publications

References 25 publications

Thyroid Function Testing in Neonates With Maternal History of Disease

Thyroid Function Testing in Neonates With Maternal History of Disease

Incidence and Interrelated Factors in Patients With Congenital Hypothyroidism as Detected by Newborn Screening in Guangxi, China

Antiseizure medications use during pregnancy and congenital malformations: A retrospective study in Saudi Arabia

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