title: Risk factors for neonatal thyroid dysfunction in pregnancies complicated by Graves' disease.
abstract: OBJECTIVE
  To determine the factors related to adverse pregnancy outcomes and neonatal thyroid dysfunction in pregnancies complicated by Graves' disease.
  
  
  METHODS
  Thirty-five pregnancies complicated by Graves' disease were divided into two groups: adverse pregnancy outcome (n=15) and no adverse pregnancy outcome (n=20). Adverse pregnancy outcomes included spontaneous abortion, stillbirth, premature delivery, fetal growth restriction, and pregnancy-induced hypertension. The 31 pregnancies resulting in live births were also divided into two groups: neonatal thyroid dysfunction (n=9) and normal neonatal thyroid function (n=22). Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4), TSH-receptor antibody (TRAb), the duration of hyperthyroidism in pregnancy, doses of antithyroid medication, and the duration of maternal antithyroid medication throughout pregnancy were compared.
  
  
  RESULTS
  There were no significant differences in these factors between pregnancies with an adverse pregnancy outcome and those with no adverse pregnancy outcome. However, serum levels of FT4, TRAb, the duration of hyperthyroidism in pregnancy, the maximum daily dose of antithyroid medication, and the total dose of antithyroid medication were significantly different between pregnancies with neonatal thyroid dysfunction and those with normal neonatal thyroid function. Multivariate logistic regression analysis showed that the FT4 level in mothers was a significant factor related to the development of neonatal thyroid dysfunction (odds ratio 28.84, 95% confidence interval 1.65-503.62, p<0.05).
  
  
  CONCLUSIONS
  Graves' disease activity in women of childbearing age should be well controlled prior to conception.
authors.affiliation: Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Mizuki
authors.initials: M
authors.lastname: Uenaka
authors.affiliation: Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Tanimura
authors.affiliation: Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Tairaku
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Morioka
authors.affiliation: Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Ebina
authors.affiliation: Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: yhideto@med.kobe-u.ac.jp.
authors.forename: Hideto
authors.initials: H
authors.lastname: Yamada
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D013956:Antithyroid Agents / Q000008:administration & dosage*; D003409:Congenital Hypothyroidism / Q000097:blood; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology; D006111:Graves Disease / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000209:etiology; D006980:Hyperthyroidism / Q000097:blood / Q000151:congenital; D018828:Immunoglobulins, Thyroid-Stimulating / Q000097:blood; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000188:drug therapy; D012307:Risk Factors; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D013997:Time Factors; D055815:Young Adult
chemical_list: D013956:Antithyroid Agents; D018828:Immunoglobulins, Thyroid-Stimulating; C094372:thyrotropin-binding inhibitory immunoglobulin; D013972:Thyrotropin; D013974:Thyroxine
keywords: Antithyroid medication; Graves’ disease; Neonatal thyroid dysfunction; Outcome