ArticleTherapeutic advances in endocrinology and metabolism2026
Maternal TPO-Ab status modulates associations between gestational thyroid hormones and neonatal TSH in 10,154 Chinese mother-newborn pairs.
Article in Therapeutic advances in endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Evidence on the maternal-fetal thyroid hormone (TH) axis is limited, especially regarding how maternal thyroid peroxidase antibody (TPO-Ab) status affects the link between gestational thyroid function and neonatal thyroid-stimulating hormone (TSH). Objectives: This study explored how maternal TH in late pregnancy influences neonatal TSH and assessed whether TPO-Ab modifies this relationship. Design: This retrospective cohort study was conducted at a tertiary specialized hospital. Methods: A total of 10,154 eligible mother-newborn pairs were analyzed. Maternal TSH, free thyroxine (FT4), free triiodothyronine (FT3), and TPO-Ab were measured before birth; neonatal TSH was measured 3-7 days postbirth. Mothers were classified as TPO-Ab positive (>34 IU/mL) or negative. Results: Maternal TPO-Ab positivity prevalence was 5.5%, while congenital hypothyroidism (CH) screening positivity (TSH ⩾10 mIU/L) occurred in 0.87% of neonates. Among TPO-Ab-negative mothers, maternal TSH positively correlated with elevated neonatal TSH (adjusted β: 0.14, 95% confidence interval (CI): 0.10-0.17, Conclusion: Maternal TSH correlates with neonatal TSH in TPO-Ab-negative pregnancies with a threshold at 4.85 mIU/L. TPO-Ab abolishes this association and reverses the FT3/FT4 ratio-neonatal TSH relationship, establishing TPO-Ab status as a critical modifier of maternal-fetal thyroid interactions. These findings support integrating TPO-Ab screening into prenatal thyroid management to optimize neonatal outcomes. However, the observational design limits causal inference, and further prospective studies are warranted.
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