ESPEYB20 1. Thyroid Antenatal and Perinatal Thyroidology (2 abstracts)
1.3. Incidence of and risk factors for neonatal hypothyroidism among women with Graves' disease treated with antithyroid drugs until delivery
Yoshihara A , Noh JY , Inoue K , Watanabe N , Fukushita M , Matsumoto M , Suzuki N , Suzuki A , Kinoshita A , Yoshimura R , Aida A , Imai H , Hiruma S , Sugino K & Ito K
JCI Insight. 2022 Nov 8;7(21):e161214. doi: 10.1172/jci.insight.161214. PMID: 36166296
Brief summary: Neonates of mothers suffering from Graves’ Disease during pregnancy are at risk for hyper- or hypothyroidism postnatally. The risk for hypothyroidism of neonates exposed to maternal anti-thyroid drugs until birth is unknown. This large retrospective study aimed at investigating 1) the incidence of hypothyroid neonates in a large cohort of mothers treated with anti-thyroid drugs until birth, and 2) identify a cutoff for maternal anti-thyroid drug doses associated with neonatal hypothyroidism.
A total of 305 pregnant women with Graves’ disease were included in this retrospective cohort study. Neonates of mothers treated with methimazole were euthyroid in 62% (39/63), showed subclinical hypothyroidism in 19% (12/63) and overt hypothyroidism in 19% (12/63). Neonates of mothers treated with propylthiouracil were euthyroid in 62% (150/242), showed subclinical hypothyroidism in 24% (57/242), and were overt hypothyroid in 13% (31/242). Four patients in the propylthiouracil group showed either subclinical or overt hyperthyroidism. Anti-thyroid drug dose during the third trimester and maternal FT4 and TRAB levels were the best predictors for neonatal hypothyroidism. The cut-off for predicting neonatal hypothyroidism was 10mg for methimazole and 150mg for propylthiouracil. In conclusion, these results allow to anticipate neonatal hypothyroidism for both treatments in newborns of mothers treated with anti-thyroid drugs until delivery. The defined cut-off doses inform adult endocrinologists to optimally titrate the anti-thyroid drug dose during the third trimester for mother and child.
Volume 20
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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