Thyroid Disease in the Pregnancy and Hypotrophy of Newborns

Czech version

Authors: V. Vargová ¹; V. Mechírová ²; M. Pytliak ³; M. Tajtáková ²
Authors‘ workplace: III. interná klinika FN LP a UP JŠ, Košice, prednosta doc. MUDr. P. Mitro, PhD. ¹; I. interná klinika FN LP a UP JŠ, Košice ²; Ústav pre bakalárske a magisterské štúdiá, LF UP JŠ, Košice ³
Published in: Ceska Gynekol 2008; 73(1): 41-46

Overview

The aim:
The aim of this study was to compare thyroidal status of mothers who delivered newborns with hypotrophy and mothers with healthy newborns.

Type of the study:
One-time cross-sectional study.

Setting:
3rd internal clinic FN LP, Košice.

Methods:
We examined 56 mothers with hypotrophic newborns and 76 mothers with healthy newborns. The protocol included anamnesis, basic physical examination, ultrasonography of the thyroid, assessment of the mother’s plasma fT4, TSH and anti-TPO levels, and comparison of the birth weight and birth length of the newborns. The results were statistically processed by PC programs StatsDirect 2.6.2 and MS Excel 2000.

Results:
The thyroid volume was significantly greater in mothers with hypotrophic newborns as in the control group (p<0.001). The birth weight and birth length was significantly lower in hypotrophic newborns (p<0.0001 resp. p<0.0001). Mothers with hypotrophic newborns had significantly higher TSH levels (p<0.0001) and higher anti-TPO levels (p<0.0001) as mothers in the control group. We found no differences in the fT4 levels in these groups.

Conclusion:
Thyroid disease of the mother can contribute to the hypotrophy of the newborns.

Key words:
thyroid, hypotrophy, IUGR, autoantibodies

Sources

1. Blazer, S., Moreh-Waterman, Y., Miller-Lotan, R., et al. Maternal hypothyroidism may affect fetal growth and neonatal thyroid function. Obstet Gynecol, 2003, 102, 2, p. 232-241.

2. Bussen, S., Steck, T., et al. Increased prevalence of thyroid antibodies in euthyroid women with a history of reccurent in-vitro fertilization failure. Hum Reprod, 2000, 15, p. 545-548.

3. Bussen, SS., Steck, T. Thyroid antibodies and their relation to antithrombin antibodies, anticardiolipin antibodies and lupus coagulant in women with reccurent spontaneus abbortions (antithyroid, anticardiolipin and antithrombin autoantibodies and lupus anticoagulant in habitual aborters). Eur J Obstet Gynecol Reprod Biol, 1997, 74, 2, p. 139-143.

4. Cohen, SB., Goldenberg, M., Rabinovici, J., et al. Anticardiolipin antibodies in fetal blood and amniotic fluid derived from patients with antiphoslipid syndrome. Hum Reprod, 2000, 15, p.1170-1172.

5. Čech, E., Hájek, Z., Maršál, K., a kol. Porodnictví. Praha: Grada Publishing, 1999, s. 165-174.

6. Davisson, RL., Hoffman, DS., Butz, GM., et al. Discovery of a spontaneus genetic mouse model of preeclampsia. Hypertension, 2002, 39, p. 337-342.

7. Deorari, AK., Aggarwal, R. Management of infants with intra-uterine growth restriction. Indian J Ped, 2001, 68, p. 1155-1157.

8. Fisher, DA. Euthyroid low thyroxine (T4) and triiodothyronine (T3) states in prematures and sick neonates. Pediatr Clin North Am, 1990, 37, p. 1297-1312.

9. Glinoer, D. The regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology. Endocr Rev, 1997, 18, p. 404-415.

10. Chatelain, P. Children born with intrauterine growth retardation (IUGR) or small for gestational age (SGA): long term growth and metabolic consequences. Endocr Reg, 2000, 33, p. 33-36.

11. Kaplan, MM. Monitoring thyroxine treatment during pregnancy. Thyroid, 1992. 2, p. 147-154.

12. Kitridou, RC. The fetus in systemic lupus erythematosus. In: Wallace, DJ., Hahn, BH., et al.: Dubois@ lupus erythematosus. 5th Ed. Baltimore: Williams & Wilkins, 1997, p. 1003-1021.

13. Klein, RZ., Carlton, EL., et al. Thyroid function in very low birthweight infants. Clin Endocrinol, 1997, 47, p. 411-417.

14. Klein, RZ., Mitchell, ML. Maternal hypothyroidism and child development. Horm Res, 1999, 52, p. 55-59.

15. Kohn, LD., Suzuki, K., Hoffman, WH., et al. Characterisation of monoclonal thyroid atimulating and thyrotropin binding inhibiting autoantibodies from a Hashimoto@s patient whose children had intrauterine and neonatal thyroid disease. J Clin Endocrinol Metab, 1997, 82, p. 3998-4009.

16. Langer, P. Patofyziológia ochorení štítnej žľazy matky v gravidite. Ochorenia štítnej žľazy v gynekologickej praxi, 1998, s. 16-17.

17. Lazár, I., Ostró, A., Dankovčík, R., et al. Skríning tyreopatií v I. trimestri gravidity. Reprodukčná medicína : zborník z vedeckej konferencie s medzinárodnou účasťou pri príležitosti 10. výročia založenia Centra asistovanej reprodukcie pri II. gynekologicko-pôrodníckej klinike LF UPJŠ a FN L. Pasteura / Editori: R. Hredzák, A. Ostró, J. Kačmárik, 2005, S. 87-88.

18. Lukačin, Š. Hypotrofia plodu, www.levret.cz, stránka postgraduálneho vzdelávania v gynekológii a pôrodníctve.

19. Millar, LK., Wing, DA., Leung, AS., et al. Low birth weight and preeclampsia in pregnancies complicated by hyperthyroidism. Obstet Gynecol, 1994, 84. 6, p.946-949.

20. Peiker, G., Glockner, R., Michels, W., et al. Serum concentrations of iodine, thyroxine (T4), triiodothyronine (T3), thyrotropin (TSH) and insulin-like growth factor 1 (IGF-1) during the last trimester of pregnancy, during labour, and in early puerperium of women with normal pregnancy or with intrauterine growth retardation (IUGR). J Obstet Gynecol, 1997, 17, 4, p. 340-343.

21. Phillips, DIW., Osmond, C., Baird, J., et al. Is birthweight associated with thyroid autoimunity? A study in twins. Thyroid, 2002, 12, 5, p. 377-380.

22. Raetti, G., Persani, L., Cortellazi, A., et al. Transplacental passage of antithyroid autoantibodies in pregnant woman with autoimmunne disease. Prenat Diagn. 1999, 19, p. 468-471.

23. Resnik, R. Intrauterine growth restriction. Obstet Gynecol, 2002, 99, p. 490-496.

24. Rohl, J., Huston-Presley, L. Factors associated with fetal growth and body composition as measured by ultrasound. Am J Obstet Gynecol, 2001, 6, p. 185-187.

25. Rushworth, FH., Backos, L., et. al. Prospective pregnancy outcome in untreated recurrent miscarries with thyroid antibodies. Hum Reprod, 2000, 7, p. 1637-1639.

26. Sher, G., Maassarani, G., Zouves, C., et al. The use of combined heparin/aspirin and immunoglobulin G therapy in the treatment of in vitro fertilization patients with antothyroid antibodies. Am J Reprod Immunol, 1998, 39, p. 223-225.

27. Stagnaro-Green, AS., Roman, SH., et al. A prospective study of lymphocyte-initiated immunosuppresion in normal pregnancy: Evidence of T-cell etiology for postpartum thyroid dysfunction, J Clin Endocrinol Metab, 1992, 74, p. 645-653.

28. Thorpe-Beeston, JG., Nicolaides, K., Snijders, JM. Thyroid function in small for gestation age fetuses. Obstet Gynecol, 1991, 77, p. 701-706.

29. Whittle, MJ. Fetal growth retardation causes and effects. Contemp Rev Obstet Gynecol, 1994, 162, p. 1168-1170.