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J Pediatr Endocrinol Metab. 2013;26(11-12):1035-40. doi: 10.1515/jpem-2013-0107.

Perinatal complications and higher risks of offspring thyroid dysfunction in early childhood of Graves' disease mothers with euthyroidism.

Abstract

AIM:

To investigate the perinatal complications and risk of thyroid dysfunction at early childhood of Graves' disease (GD) mothers with euthyroidism (EU) or subclinical hyperthyroidism (sHT) during pregnancy.

METHOD:

One hundred and twenty-three pregnant women with GD were recruited. They were all in euthyroidism with treatment of anti-thyroid drugs (ATDs) before pregnancy. All the pregnant GD women maintained EU (n=55) or sHT (n=68) by using ATDs. Sixty randomly selected, age-matched healthy pregnant women (non-GD control) were included. The prenatal and newborn data were collected and analyzed. Toddlers of GD mothers (n=45) and non-GD healthy mothers (n=36) were also recruited for thyroid function and growth assessments.

RESULTS:

Newborns of mothers with GD had significantly higher complications than those of non-GD mothers. The percent of perinatal complications were 5.0%, 30.9% and 32.3% in the control, EU (vs. control, p<0.001), and sHT (vs. control, p<0.001) groups, respectively. There were no differences between the women continuing low doses of ATDs at the start of pregnancy and the women who stopped receiving ATDs at the start of pregnancy. Toddlers' serum levels of FT3, FT4, anti-thyroglobulin antibody, and anti-thyroid peroxidase antibody were significantly higher than those of non-GD mothers (all p<0.05).

CONCLUSION:

Pregnancy with GD significantly increases the perinatal complications even with EU. The continued use of ATDs at the start of pregnancy does not give an increased risk of perinatal complications in GD mothers. Maternal GD may also induce a higher risk of autoimmue thyroid dysfunction among offspring at early childhood.

PMID:
23893675
[PubMed - indexed for MEDLINE]
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