ESPE2021 ePoster Category 1 Thyroid B (10 abstracts)
Management of newborns born to mothers with autoimmune hypothyroidism
Paolo Cavarzere 1 , Laura Palma 1 , Marta Camilot 1 , Monica Vincenzi 1 , Francesca Teofoli 1 , Lara Nicolussi Principe 1 , Rossella Gaudino 1 , Virginia Murri 2 , Orsiol Pepaj 3 , Luigi Lubrano 4 , Giuliana Rossi 5 , Alessia Sallemi 6 , Ermanna Fattori 7 , Silvana Lauriola 8 & Franco Antoniazzi 1
1Pediatric Division, Department of Pediatrics, University Hospital of Verona, Verona, Italy; 2Pediatric Division, Hospital of San Bonifacio, Verona, Italy; 3Pediatric Division, Hospital of Villafranca, Verona, Italy; 4Pediatric Division, Hospital of Legnago, Verona, Italy; 5Pediatric Division, Hospital of Mestre, Mestre, Italy; 6Pediatric Division, Hospital of Venezia, Venezia, Italy; 7Pediatric Division, Hospital of Negrar, Negrar (Verona), Italy; 8Neonatal Intensive Cure Unit, Department of Pediatrics, University Hospital of Verona, Verona, Italy
Background: Maternal autoimmune hypothyroidism can have negative consequences on the fetus: on the one hand, maternal hypothyrosinemia might affect the fetal brain development in the early stages of pregnancy; on the other, thyroid inhibiting antibodies can pass through the placenta. It is currently unclear if these antibodies may affect the newborn’s thyroid function. Consequently, there are no certain indications regarding the management of newborns born to mothers with autoimmune hypothyroidism.
Aims: The purpose of the study is to verify the utility of the serum thyroid function test in newborns born from mothers with autoimmune hypothyroidism.
Methods: All newborns born at term, with mother suffering from autoimmune hypothyroidism and with negative neonatal screening for congenital hypothyroidism (CH), were tested for serum thyroid function by measurement of free thyroxine (FT4) and thyroid stimulating hormone (TSH) in 15th-20th day of life. In the same session a second dried blood spot was collected. Data concerning maternal replacement therapy with L-thyroxine during pregnancy were retrospectively collected.
Results: From November 2019 to March 2020 in Verona (Italy), we found 54 newborns born to mothers with autoimmune hypothyroidism. No extra cases of CH were detected and no infants required replacement therapy. We found a good concordance between the results of serum thyroid function and the dried blood spot at 15-20 days of life.
Conclusions: The prevalence of maternal autoimmune hypothyroidism in our study was 1: 29. Therefore, it is not a rare condition and the management of these newborns needs to be carefully defined. We suggest that newborns born to mothers affected by autoimmune hypothyroidism should be submitted to only a second dried blood spot between 2nd and 4th weeks of life. If hormone values result in the normal referring range, no additional test should be performed.
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