ArticleItalian journal of pediatrics2025
An analysis of real-life data of infants born to mothers with autoimmune thyroiditis: do they need to be followed-up?
Article in Italian journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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11 authors.
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Abstract
backgroundInfants born to mothers with autoimmune thyroiditis (AT) could be at risk of developing thyroid dysfunction, and maternal anti-thyroid antibodies have been shown to have a clinical impact on offspring. We aimed at evaluating the usefulness of our follow-up intervention protocol in newborns from mothers with AT and to define the most appropriate management for these neonates.
methods89 mothers with AT and their newborns were included. Data on maternal thyroid function and autoimmunity were collected; serum thyroid function and autoimmunity of infants were assessed regularly until normalisation of thyroid stimulating hormone (TSH) and anti-thyroid antibodies, according to the local protocol.
resultsThyroid auto-antibodies were measured in 38% and in 62% of mothers before and during pregnancy, respectively. Anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) were positive in 97% and 61%, respectively, of the mothers assessed. Anti-TSH receptor antibodies (TRAb) were checked in 18% of the mothers and all were negative. 94% of newborns at first evaluation had positive anti-thyroid antibodies, starting to normalise or decrease from the second month of life. Analysing TSH levels according to the days of postnatal life of collection samples (T1: 30 ± 7 days, T2: 61 ± 9 days, T3: 105 ± 49 days, T4: 135 ± 31 days, T5: 247 ± 64 days), peak TSH levels were found at T4 (4.4 ± 2.2 mU/L), within the cut-off of 6 mU/L. 84% of children maintained a normal thyroid function during follow-up; 12% of infants presented a TSH above 6 mU/L at least in one blood test, showing normalisation during follow-up. Only one infant received replacement therapy for hypothyroidism at 2 months. 91% of the 22 thyroid ultrasounds (US) performed were normal. In those with changes thyroid function normalised anyway.
conclusionsMothers with AT do not seem to deliver newborns at risk of overt hypothyroidism. However, because of the possible negative effects of maternal anti-thyroid antibodies, we underline the importance of monitoring thyroid autoimmunity during pregnancy, including both anti-TG besides anti-TPO antibodies.
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