Antithyroid drug treatment of Graves' disease in pregnancy: long-term effects on somatic growth, intellectual development and thyroid function of the offspring.
With regard to their thyroid function, somatic and intellectual development, we compared 17 children of 13 hyperthyroid mothers (group I) receiving antithyroid drug treatment during their pregnancies with 25 children of 15 mothers who were euthyroid without any antithyroid treatment during their pregnancy (group II). Mean duration of maternal treatment was 3.5 months in group I, using carbimazole or thiamazole (N = 12) and propylthiouracil (N = 1). Age at examination in group I was 7.2 +/- 6.2 years, in group II 8.7 +/- 7.1 years (mean +/- SD). Both groups showed no significant differences in the results of the clinical examination and in the degree of their mental and psychomotoric development at the time of study. We found the mean birth weight of the infants in group I significantly lower than in group II (3165 +/- 339 vs 3666 +/- 670 g, p less than 0.03). The individual birth weights, however, were normal for gestational age. The body weight difference between groups disappeared during the further somatic development of the children. The serum concentration of free thyroxine in group I was significantly higher than in group II (17.2 +/- 2.4 vs 14.9 +/- 1.9 pmol/l, p less than 0.003), but fell in both groups within the normal range. The evaluation of the psychomotoric and intellectual capacity of the children at different developmental stages showed no abnormalities detectable by our tests. Thus, in the children of the two groups we found no adverse effects of a maternal antithyroid drug treatment during pregnancy or of inactive maternal Graves' disease alone, neither on thyroid gland size and function nor on the physical or intellectual development, after the neonatal period.
Messer
P M
PM
Department of Internal Medicine, University Essen, Berlin, FRG.
Hauffa
B P
BP
Olbricht
T
T
Benker
G
G
Kotulla
P
P
Reinwein
D
D
D001724:Birth Weight / Q000187:drug effects; D002231:Carbimazole / Q000627:therapeutic use; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000188:drug therapy*; D006128:Growth / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D007360:Intelligence / Q000187:drug effects*; D008431:Maternal-Fetal Exchange; D008713:Methimazole / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications; D011297:Prenatal Exposure Delayed Effects; D011441:Propylthiouracil / Q000627:therapeutic use; D013961:Thyroid Gland / Q000187:drug effects*; D013972:Thyrotropin / Q000096:biosynthesis; D013974:Thyroxine / Q000096:biosynthesis; D014284:Triiodothyronine / Q000096:biosynthesis
D014284:Triiodothyronine; D008713:Methimazole; D011441:Propylthiouracil; D002231:Carbimazole; D013972:Thyrotropin; D013974:Thyroxine