Vidal EA, De las Heras IS, Cuadrado MMM, Domingo Cl, García PB, Lesmes ML, Rivero MMJ

Language: Spanish
References: 20
Page: 560-569
PDF size: 222.44 Kb.

ABSTRACT

Introduction: One of the most common endocrinological diseases in pregnant women is autoimmune thyroid pathology. It is associated with important maternal, fetal and neonatal complications.
Objective: To describe the characteristics and impact of maternal autoimmune thyroid disease in newborns.
Materials and Methods: Observational, longitudinal, descriptive and retrospective study of 200 newborns who´s mothers suffered from autoimmune thyroid pathologies for the period spanning from January 2019 to December 2020.
Results: 6.64% had autoimmune thyroid pathology. 66.5% presented autoimmune thyroid disease prior to pregnancy and with a diagnosis of hypothyroidism in 83.5%. 33.5% developed thyroid alteration during pregnancy, with a diagnosis of hypothyroidism in 97%. The mean value of maternal hormones was: median TSH: 3.14 mIU/ml; mean T4: 0.79 ± 0.17 ng/dl. In neonates the mean hormone levels at 15 days of life were: TSH: 4.16 ± 2.26 mIU/ml; T4: 1.2 ± 0.19 ng/dl. Three patients (children who´s mothers had autoimmune hypothyroidism) were diagnosed with congenital hypothyroidism.
Conclusions: The implementation of a standard actuation protocol, complementary to neonates screening, becomes necessary.

REFERENCES

1. Cavarzere P, Palma L, Nicolussi Principe L, Vincenzi M, LauriolaS, Gaudino R, Murri V, et al. Benefits of rescreeningnewborns of mothers affected by autoimmune hypothyroidism.Eur Thyroid J. 2022 Aug 5;11(5):e220060

2. Van Trotsenburg ASP. Management of neonates born tomothers with thyroid dysfunction, and points for attentionduring pregnancy. Best Pract Res Clin Endocrinol Metab.2020 Jul;34(4):101437.

3. Ben-Zeev ZS, Peniakov M, Felszer C, Weiner SA, Lahad A,Almashanu S, Tenenbaum Rakover Y. Usefulness of thyroidfunction assessment in infants born to mothers withthyroid dysfunction during pregnancy. Eur Thyroid J. 2022Jun 23;11(4):e220055.

4. Yokomichi H, Mochizuki M, Kojima R, Horiuchi S, OokaT, Akiyama Y, Miyake K, Kushima M, Otawa S, ShinoharaR, Yamagata Z. Mother's iodine exposure and infants'hypothyroidism: the Japan Environment and Children'sStudy (JECS). Endocr J. 2022 Jan 28;69(1):9-21.

5. Leung AM. Thyroid function in pregnancy. J Trace ElemMed Biol. 2012 Jun;26(2-3):137-40.

6. Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H,Dosiou C, Grobman WA, Laurberg P, Lazarus JH, MandelSJ, Peeters RP, Sullivan S. 2017 Guidelines of the AmericanThyroid Association for the Diagnosis and Management ofThyroid Disease During Pregnancy and the Postpartum.Thyroid. 2017 Mar;27(3):315-389.

7. Yim CH. Update on the Management of Thyroid Diseaseduring Pregnancy. Endocrinol Metab (Seoul). 2016Sep;31(3):386-391.

8. Cooper DS, Laurberg P. Hyperthyroidism in pregnancy.Lancet Diabetes Endocrinol. 2013 Nov;1(3):238-49.

9. De Groot L, Abalovich M, Alexander EK, Amino N, BarbourL, Cobin RH, Eastman CJ, Lazarus JH, Luton D, Mandel SJ,Mestman J, Rovet J, Sullivan S. Management of thyroiddysfunction during pregnancy and postpartum: an EndocrineSociety clinical practice guideline. J Clin EndocrinolMetab. 2012 Aug;97(8):2543-65.

10. Krassas GE, Poppe K, Glinoer D. Thyroid function and humanreproductive health. Endocr Rev. 2010 Oct;31(5):702-55.

11. Yadav V, Dabar D, Goel AD, Bairwa M, Sood A, Prasad P,Agarwal SS, Nandeshwar S. Prevalence of Hypothyroidismin Pregnant Women in India: A Meta-Analysis of ObservationalStudies. J Thyroid Res. 2021 Feb 19;2021:5515831.

12. Anandappa S, Joshi M, Polanski L, Carroll PV. Thyroiddisorders in subfertility and early pregnancy. Ther AdvEndocrinol Metab. 2020 Oct 13;11:2042018820945855.

13. Temboury Molina MC, Rivero Martín MJ, de Juan Ruiz J,Ares Segura S. Enfermedad tiroidea autoinmunitaria materna:repercusión en el recién nacido [Maternal autoimmunethyroid disease: relevance for the newborn]. Med Clin(Barc). 2015 Apr 8;144(7):297-303. Spanish.

14. Spencer L, Bubner T, Bain E, Middleton P. Screening andsubsequent management for thyroid dysfunction prepregnancyand during pregnancy for improving maternaland infant health. Cochrane Database Syst Rev. 2015 Sep21;2015(9):CD011263.

15. Ares S S, Temboury M C, Chueca G MJ, Grau B G, Alija MMJ, Caimari J M, et al. Recommendations for the diagnosisand follow up of the foetus and newborn child born tomothers with autoimmune thyroid disease. An Pediatr(Barc). 2018;89(4):254.e1-254.e7.

16. Temboury Molina MC, Rivero Martín MJ, de Juan RuizJ, Ares Segura S. Enfermedad tiroidea autoinmunitariamaterna: repercusión en el recién nacido. Med Clin (Barc).2015;144(7):297-303.

17. Lara Orejas E, Retuerta Oliva A, Rodríguez Riero C, RuibalFrancisco JL. Estudio longitudinal de una población de 92pacientes, hijos de madres con hipotiroidismo autoinmune.Revista Española Endocrinología pediátrica. 2012;3 Supl1:188-198.

18. Sanz Fernández M, Rodríguez Sánchez A, González Ruiz deLeón E. Patología tiroidea en el niño y en el adolescente.Revista Pediatría Integral. 2015;19 Supl 7:467-476.

19. Sociedad Española de Endocrinología Pediátrica. Actualizaciónsobre hipotiroidismo y disfunción tiroidea en la infanciay adolescencia. Rev Esp Endocrinol Pediatr. 2014;5(2).

20. Henrichs J, Bongers-Schokking JJ, Schenk JJ, GhassabianA, Schmidt HG, Visser TJ, et al. Maternal thyroid functionduring early pregnancy and cognitive functioning in earlychildhood: The generation R study. J Clin Endocrinol Metab.2010;95:4227–34.