Hashimoto thyroiditis in mother and thyroid function in offspring – a prospective study

Abstract

Autoimmune thyroid disease (AITD) is diagnosed in 5-20% of pregnant women. Autoimmune thyroid disease in mother may be a cause of thyroid dysfunction in child. Hypothyroidism induced by thyrotropin receptor blocking antibodies (TRBAb) is present in 1-2% of children with congenital hypothyroidism. The aim of this paper was to evaluate thyroid function and presence of antithyroid antibodies in children of mothers with Hashimoto thyroiditis in the first year of life. Material and methods. 367 children were included into the study (185 boys, 182 girls, two twin pregnancies) of mothers with Hashimoto thyroiditis. The first visit in endocrinology out-patient clinic was done in 1 st -2 nd month of life, the follow-up visit at 6 th -9 th month of life. Anthropometrics were taken as well as blood samples for TSH, fT3, fT4, ATPO and ATG. Mothers had all proper thyroid function during the whole pregnancy. Results. 339 children (92,4%) were born on term, 281 (76,6%) with normal vaginal delivery, in good condition and with proper body mass. In three patients trisomy 21 was diagnosed. The neurological development of all children was not concerning. Thyroid function was proper (mean TSH 5,41±0,90 μIU/ml, fT3 8,00±1,24 pg/ml, fT4 16,89±2,09 pmol/l). None of the observed child had elevated titer of antithyroid antibodies. Conclusions. 1. Malfunction of the thyroid gland in children of mothers with Hashimoto thyroiditis is rare, therefore no further diagnostic procedures except screening test is required. 2. In preterm babies as well as in children presenting chaSłowa kluczowe choroba Hashimoto, autoimmunizacyjna choroba tarczycy, wrodzona niedoczynność tarczycy StreszczenieAutoimmunizacyjną chorobę tarczycy (AITD, autoimmune thyroid disease) rozpoznaje się u 5-20% ciężarnych. AITD u matki może być przyczyną dysfunkcji tarczycy u dziecka. Niedoczynność tarczycy wywołana przez przeciwciała blokujące receptor TSH (TRBAb, thyrotropin receptor blocking antibodies) występuje u 1-2% dzieci z wrodzoną niedoczynnością tarczycy. Celem pracy była ocena funkcji tarczycy oraz obecności przeciwciał przeciwtarczycowych u dzieci matek chorujących na przewlekłe limfocytarne zapalenie tarczycy typu Hashimoto w pierwszym roku ich życia. Materiał i metody. Badaniem objęto 367 dzieci (185 chłopców oraz 182 dziewczynki, dwie ciąże bliźniacze) urodzonych przez matki chorują-ce na chorobę Hashimoto. Odbyły się dwie wizyty w poradni endokrynologicznej: w 1-2 miesiącu życia i w 6-9 miesiącu życia. Wykonano pomiary antropometryczne oraz pobrano krew w celu oceny stężenia TSH, fT3, fT4, ATPO, ATG. Funkcja tarczycy u matek była wyrównana w czasie całej ciąży. Wyniki. 339 dzieci (92,4%) było urodzonych o czasie, 281 (76,6%) siłami natury, wszystkie w stanie dobrym i z prawidło-wą masą ciała. U trojga rozpoznano trisomię 21. Rozwój psychomotoryczny w czasie obserwacji nie budził niepokoju. Funkcja tarczycy u wszystkich dzieci była prawidłowa (średnie TSH 5,41±0,90 μIU/ml, fT3 8,00±1,24 pg/ml, fT4 16,89±2,09 pmol/l). U żadne-go dziecka nie stwierdzono ...

The influence of thyroid function disorders on pregnant women on the Apgar scale and psychomotor development of the child in the first 18 months of life

“…From the analysis of the collected material statistical significance in analyzing the impact of Hashimoto on the week of birth, child's birth weight, Apgar score or problems in a child's development up to 18 months of age is not achieved. The same conclusion presented was presented by Zubkiewicz-Kucharska et al The authors in their study have examined 367 children, of which, up to 94% of the children received a good Apgar score (8 to 10) [4]. Similar to the results of their research have been obtained by Plowden, who also did not show that Hashimoto affects premature labor and complications in children.…”

“…The Apgar score is commonly used to assess the health status of a newborn specific minutes after birth. In their research, Zubkiewicz-Kucharska showed no effect on pregnant hypothyroidism on the Apgar scale [4]. No significant correlation was shown between the results of the Apgar score and developmental disabilities in children in the future.…”

“…This result is consistent with the common knowledge that the problem of impaired thyroid function in children of women with Hashimoto's thyroiditis applies only to 2.5%. It is therefore considered that the screening tests are sufficient after the delivery without the need for further diagnosis [4,9].…”

“…One of the common problems among pregnant women in the area of thyreology is hypothyroidism, which occurs at a frequency of 0.5% to 3.5% of the population [1]. Hypothyroidism is divided into full hypothyroidism (referred to as elevated levels of thyroidstimulating hormone [TSH] and decreased concentration of hormone thyroxine [FT4], or TSH> 10mlU / l FT4 reference range) subclinical hypothyroidism (defined as the TSH concentration above the upper limit FT4 within the reference range) and insulated hypothyroidism (referred to as FT4 decreased concentration of hormone and TSH hormone concentration within the reference range) [2,3,4]. The main causes of hypothyroidism in pregnant women pertain to iodine deficiency and chronic lymphocytic Hashimoto's thyroiditis.…”