Follow-up of infants born to mothers with autoinmune thyroid disease. What should not be screened?

• Published in: Endocrinología, diabetes y nutrición. diabetes y nutrición., 2020-03, Vol.67 (3), p.172-178
• Main Authors: Marín Urueña, S.I., Infante López, M.E., Samaniego Fernández, C.M., Montejo Vicente, M.M., Escribano García, C., Izquierdo Caballero, R., Mulero Collantes, I., Caserío Carbonero, S.
• Format: Article
• Language: English
• Subjects: Autoimmune hypothyroidism; Cribado neonatal tiroideo; Enfermedad de Graves; Graves disease; Hipertirotropinemia; Hipotiroidismo autoinmune; Hyperthyrotropinemia; Neonatal thyroid screening; Thyroiditis; Tiroiditis
• ISSN: 2530-0180; 2530-0180
• DOI: 10.1016/j.endien.2020.04.004

Thyroid dysfunction is a common problem in pregnant women. It is usually of an autoimmune origin, with Hashimotós thyroiditis and Graveś disease being the most common conditions. Although hormonal changes and transplacental antibody transfer may occur, specific neonatal screening has not been shown to be useful. A prospective study of newborns of women with autoimmune thyroid disease born at a level III university hospital (November 2013–December 2016). Neonates were selected during their stay at the maternity. Babies with perinatal asphyxia were excluded. Data were collected from the clinical histories of mothers and newborns. A total of 191 neonates were included. Ninety percent of mothers had been diagnosed with autoimmune hypothyroidism. Only 5.8% of newborns had some laboratory disorder, consisting of slightly increased thyroid-stimulating hormone levels, which returned to normal at the age of one month and did not correlate to thyroid peroxidase antibody levels. Transient hyperthyrotropinemia was diagnosed in one newborn and required thyroxin treatment during the first year of life. Among newborns from mothers with Graveś disease, 36.8% had some abnormal laboratory value during the first 7 days of life, but there were no cases of hyperthyroidism and only one of transient hyperthyrotropinemia. Experience at our hospital in screening of newborns from hypothyroid mothers reveals a high number of laboratory controls with a poor diagnostic yield. No relationship was found between thyroid peroxidase antibody levels and thyroid dysfunction. We support the recommendations to continue testing serum thyroid-stimulating hormone and FT4 levels at 48 h of life in newborns of mothers with autoimmune hypothyroidism. La patología tiroidea es un problema frecuente en las mujeres embarazadas. Su etiología suele ser autoinmune siendo la tiroiditis de Hashimoto y la enfermedad de Graves las entidades principales. A pesar de las posibles alteraciones hormonales y del paso transplacentario de anticuerpos estimulantes, la realización de un cribado neonatal específico no ha demostrado su utilidad en el neonato. Estudio prospectivo (noviembre de 2013-diciembre de 2016) de los hijos de madre con patología tiroidea autoinmune nacidos en un hospital universitario nivel III. Los recién nacidos se seleccionaron en maternidad. Se excluyeron los casos de asfixia perinatal. Los datos se recogieron de las historias clínicas de madres y recién nacidos. Se incluyeron 191 recién nacidos