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PP-24. Maternal thyroid dysfunction and neonatal thyroid problems
S28
Abstracts
PP-24. Maternal thyroid dysfunction and neonatal thyroid problems
Aim
Hulya Ozdemira, İpek Akmanaa, Senay Coskuna, Utku Demirela, Serap Turanb, Abdullah Bereketb, Hulya Bilgena, Eren Ozeka a Marmara University Medical School, Department of Neonatology, Turkey b Department of Pediatric Endocrinology, Turkey
The objectives of our study are to determine the frequency and severity of jaundice in neonates the last 10 years and to present the causes. Materials and methods
Aim Hypothyroidism during pregnancy may cause postnatal thyroid dysfunction in the neonate. The aim of this study is to investigate obstetric features of pregnant women with thyroid disorders and thyroid function tests of their newborn infants. Materials and methods Thirty-four mothers with thyroid problems during pregnancy and their newborns were enrolled. Thyroid function test results, antibody titers and clinical features of the patients were reviewed. Women with positive anti-thyroglobulin (ATG) and anti-thyroid peroxidase titers (anti-TPO) were assigned as group I (n = 13), and women with hypothyroidism who did not have autoantibodies were assigned as group II (n = 21). SPSS 13.0 was used for statistical analysis. Results History of spontaneous abortion was more frequent in group I compared to group II. (71% vs 7%; p = 0.02). Preterm birth rate was higher in group I compared to group II (61% vs 23%; p = 0.05). Six infants in group I (40%) had positive anti-TPO titers at the end of 1st postnatal week. Mean maternal TPO titers were significantly higher in infants with positive TPO titers compared to infants with negative titers (362.6 ± 115 IU/ml vs .47.8 ± 7.4 IU/ml; p = 0.001). In group I, one infant was diagnosed with compensated hypothyroidism and one had transient hyperthyrotropinemia. Five infants (22.7%) in group II had transient hyperthyrotropinemia. Only three of them had thyroid stimulating hormone (TSH) level >7 μIU/ml at the 3rd postnatal week. Median TSH levels of mothers of these five infants with transient hyperthyrotropinemia was 6.6 (3.2–7.8) mIU/ml. In the follow-up, all TSH values returned to normal ranges at the 8th postnatal week. Conclusions Spontaneous abortus and preterm birth rates are higher in women with autoimmune thyroid disease. Infants born to mothers with high anti-TPO titers are prone to have abnormal thyroid function tests. Transient hyperthyrotropinemia was common in infants of hypothyroid mothers who had inadequate thyroid hormone replacement treatment during pregnancy. Women with thyroid disorders and their newborn infants should be followed closely.
doi:10.1016/j.earlhumdev.2010.09.077
PP-25. Factors that contribute in the appearance of neonatal jaundice. 10 years study Anna Pantazi, Dimitrios Papadimitriou, Hacer Hasan, Eleni Kifnidou, Eleni Karanikolaou, Eleni Sotiriou, Sıdıka Tahir, Maria Iordanidou, Athanasios Tsolakidis General Hospital of Komotini “Sismanogleio”, Pediatric Clinic, Greece
We studied 3620 neonates who were born the last 10 years. We recorded demographic data, pregnancy and labor conditions, clinical and laboratory findings of neonates and mothers. Newborns were divided in three groups: 1. bilirubin <8 mg/dl, 2. 8–13 mg/dl, 3. >13 mg/dl, which were studied separately. Results In a total of 3620 neonates that were born the last 10 years, 3% were premature. 31% of full-term neonates appeared with jaundice. Of these, 16% had total bilirubin >13 mg/dl. In the group: <8 mg/dl, 49% were firstborn children and 13% of them were born through a cesarean section (CS). Mother age was older than 35 years in 4%. Out of 43% of neonates that had total bilirubin 8–13 mg/dl, 54% were firstborn and 22% were born through a CS. Total bilirubin >13 mg/dl was counted in 16% of neonates. In this group 60% were males, 54% were firstborn and 17% were delivered through a CS. 1% of mothers were older than 35 years. 27% of neonates in this group had total bilirubin >16 mg/dl. 11% of mothers gained >20 kg and 15% smoked during pregnancy. 46% of these neonates had ABO and 6% had Rhesus incompatibility. Conclusions Neonatal jaundice has a variety of causes. According to our study 1/3 of neonates with jaundice belong to low socioeconomic communities and appear more frequently in firstborn children. Most of them present with low levels of bilirubin (<13 mg/dl) and the most common cause was ABO incompatibility. doi:10.1016/j.earlhumdev.2010.09.078
PP-26. A case of foetal valproate syndrome Raghavendra Subba Rao, Deborah Eadie, Giles Richardson Derriford Hospital, Plymouth, UK Aim Sodium valproate is a widely used antiepileptic drug and the potential teratogenic effects are well documented. We report a newborn infant with features suggestive of Foetal Valproate Syndrome (FVS). Case presentation Baby mucormycosis (MM) was born at 39 weeks gestation, weighing 2.9 kg, by spontaneous vaginal delivery. His 35 year old mother had her first seizure at the age of 16 and was commenced on sodium valproate at a dose of 400 mg/day. She had since given birth to two healthy children whilst remaining on her treatment. Following an ectopic pregnancy 3 years ago she reported some abnormal twitching movements and her dose of medication was increased to 2000 mg/day by her GP. She has never been under the care of a specialist for her epilepsy and has never had a recurrence of abnormal movements. This pregnancy was uneventful. Apgars: 6, 7 and 8 at 1, 5 and 10 min respectively. He required one day of non-invasive respiratory support. His features
Abstracts
PP-24. Maternal thyroid dysfunction and neonatal thyroid problems
Aim
Hulya Ozdemira, İpek Akmanaa, Senay Coskuna, Utku Demirela, Serap Turanb, Abdullah Bereketb, Hulya Bilgena, Eren Ozeka a Marmara University Medical School, Department of Neonatology, Turkey b Department of Pediatric Endocrinology, Turkey
The objectives of our study are to determine the frequency and severity of jaundice in neonates the last 10 years and to present the causes. Materials and methods
Aim Hypothyroidism during pregnancy may cause postnatal thyroid dysfunction in the neonate. The aim of this study is to investigate obstetric features of pregnant women with thyroid disorders and thyroid function tests of their newborn infants. Materials and methods Thirty-four mothers with thyroid problems during pregnancy and their newborns were enrolled. Thyroid function test results, antibody titers and clinical features of the patients were reviewed. Women with positive anti-thyroglobulin (ATG) and anti-thyroid peroxidase titers (anti-TPO) were assigned as group I (n = 13), and women with hypothyroidism who did not have autoantibodies were assigned as group II (n = 21). SPSS 13.0 was used for statistical analysis. Results History of spontaneous abortion was more frequent in group I compared to group II. (71% vs 7%; p = 0.02). Preterm birth rate was higher in group I compared to group II (61% vs 23%; p = 0.05). Six infants in group I (40%) had positive anti-TPO titers at the end of 1st postnatal week. Mean maternal TPO titers were significantly higher in infants with positive TPO titers compared to infants with negative titers (362.6 ± 115 IU/ml vs .47.8 ± 7.4 IU/ml; p = 0.001). In group I, one infant was diagnosed with compensated hypothyroidism and one had transient hyperthyrotropinemia. Five infants (22.7%) in group II had transient hyperthyrotropinemia. Only three of them had thyroid stimulating hormone (TSH) level >7 μIU/ml at the 3rd postnatal week. Median TSH levels of mothers of these five infants with transient hyperthyrotropinemia was 6.6 (3.2–7.8) mIU/ml. In the follow-up, all TSH values returned to normal ranges at the 8th postnatal week. Conclusions Spontaneous abortus and preterm birth rates are higher in women with autoimmune thyroid disease. Infants born to mothers with high anti-TPO titers are prone to have abnormal thyroid function tests. Transient hyperthyrotropinemia was common in infants of hypothyroid mothers who had inadequate thyroid hormone replacement treatment during pregnancy. Women with thyroid disorders and their newborn infants should be followed closely.
doi:10.1016/j.earlhumdev.2010.09.077
PP-25. Factors that contribute in the appearance of neonatal jaundice. 10 years study Anna Pantazi, Dimitrios Papadimitriou, Hacer Hasan, Eleni Kifnidou, Eleni Karanikolaou, Eleni Sotiriou, Sıdıka Tahir, Maria Iordanidou, Athanasios Tsolakidis General Hospital of Komotini “Sismanogleio”, Pediatric Clinic, Greece
We studied 3620 neonates who were born the last 10 years. We recorded demographic data, pregnancy and labor conditions, clinical and laboratory findings of neonates and mothers. Newborns were divided in three groups: 1. bilirubin <8 mg/dl, 2. 8–13 mg/dl, 3. >13 mg/dl, which were studied separately. Results In a total of 3620 neonates that were born the last 10 years, 3% were premature. 31% of full-term neonates appeared with jaundice. Of these, 16% had total bilirubin >13 mg/dl. In the group: <8 mg/dl, 49% were firstborn children and 13% of them were born through a cesarean section (CS). Mother age was older than 35 years in 4%. Out of 43% of neonates that had total bilirubin 8–13 mg/dl, 54% were firstborn and 22% were born through a CS. Total bilirubin >13 mg/dl was counted in 16% of neonates. In this group 60% were males, 54% were firstborn and 17% were delivered through a CS. 1% of mothers were older than 35 years. 27% of neonates in this group had total bilirubin >16 mg/dl. 11% of mothers gained >20 kg and 15% smoked during pregnancy. 46% of these neonates had ABO and 6% had Rhesus incompatibility. Conclusions Neonatal jaundice has a variety of causes. According to our study 1/3 of neonates with jaundice belong to low socioeconomic communities and appear more frequently in firstborn children. Most of them present with low levels of bilirubin (<13 mg/dl) and the most common cause was ABO incompatibility. doi:10.1016/j.earlhumdev.2010.09.078
PP-26. A case of foetal valproate syndrome Raghavendra Subba Rao, Deborah Eadie, Giles Richardson Derriford Hospital, Plymouth, UK Aim Sodium valproate is a widely used antiepileptic drug and the potential teratogenic effects are well documented. We report a newborn infant with features suggestive of Foetal Valproate Syndrome (FVS). Case presentation Baby mucormycosis (MM) was born at 39 weeks gestation, weighing 2.9 kg, by spontaneous vaginal delivery. His 35 year old mother had her first seizure at the age of 16 and was commenced on sodium valproate at a dose of 400 mg/day. She had since given birth to two healthy children whilst remaining on her treatment. Following an ectopic pregnancy 3 years ago she reported some abnormal twitching movements and her dose of medication was increased to 2000 mg/day by her GP. She has never been under the care of a specialist for her epilepsy and has never had a recurrence of abnormal movements. This pregnancy was uneventful. Apgars: 6, 7 and 8 at 1, 5 and 10 min respectively. He required one day of non-invasive respiratory support. His features