Neonatal effects of thyroid diseases in pregnancy and approach to the infant with increased TSH: Turkish Neonatal and Pediatric Endocrinology and Diabetes Societies consensus report

Abstract

Thyroid functions in the fetus and newborn carry importance in terms of the baby’s health and development of the central nervous system. Maternaliodine deficiency, exposure to iodine, thyroid diseases (Hashimoto thyroiditis, Graves’) and drugs used by the mother affect thyroid functions in the fetus. Reflections of these effects are observed immediately after delivery. Investigation of the mother in terms of thyroid diseases during pregnancy, recognition and appropriate assessment of the required conditions, screening of all newborns in the first days of life in terms of congenital hypothyroidism, timely and appropriate evaluation of the screening results, early diagnosis and appropriate treatment of cases of congenital hypothyroidism, assessment and management of cases of transient thyroid hormone disorders and close monitoring of the thyroid functions and development of patients in whom treatment has been initiated with a diagnosis of hypothyroidism are crucial in terms of developmental outcomes of the babies who have thyroid function disorders or hypothyroidism. This guideline was written with the objective of guiding pediatricians, neonatologists and pediatric endocrinologists in the issue of assessment, diagnosis and management of thyroid function disorders and thyroid diseases concerning the fetus and baby during gestation and neonatal period.

Effect of Maternal Subclinical Hypothyroidism on Congenital Hypothyroidism Screening Results: A Retrospective Cohort Study

“…In our study, rates of recall and CH were 5.34% and 0.33% among all neonates, regardless of maternal thyroid status. In Turkey, the prevalence of CH during our study period was high, at approximately 1/400 17 . The current high CH rates in Turkey can be explained by a significant iodine deficiency in pregnant women 22 .…”

“…If the TSH value is higher than 20 mIU/L in the first heel blood sample or higher than 5.5 mIU/L in repeated heel blood samples, the newborn is referred to a neonatologist or pediatric endocrinologist for evaluation. The request for repeat blood sampling or referral to a specialist or pediatric endocrinologist is referred to as "recall" 16,17 .…”

Iodine Status in Pregnancy and Lactation

“…30 DÜNYA'DA DURUM 1990 yılına kadar yalnızca birkaç ülkede (Avustralya, Amerika Birleşik Devletleri (ABD), Kanada, İsviçre ve bazı İskandinav ülkeleri) iyot yeterli düzeydeydi. 31 37 Ülkemizde gebelerin iyot durumunu araştıran çalışmalar genellikle yerel ve küçük grupları kapsamaktadır. Anaforoğlu ve ark.…”

Bioinformatics analysis of key genes and pathways in Hashimoto thyroiditis tissues

“…Some studies have reported that HT causes severe cardiac effusion or cardiac tamponade independently or synergistically with other disease [10]. Excessively high titer of TPOAb and TGAb may cross blood-fetal barrier and lead to antenatal and neonatal disorders in pregnant patients [11].…”