Neurodevelopmental Follow-Up of Children Born to Mothers with Graves’ Disease and Neonatal Hyperthyroidism

• Published in: Hormone research in paediatrics Vol. 98; no. 3; pp. 336 - 343
• Main Authors: Grob, Francisca, Brown, Amy, Zacharin, Margaret
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland 01.06.2025
• Subjects: Adult; Child; Child, Preschool; Female; Follow-Up Studies; Graves Disease - complications; Graves Disease - physiopathology; Humans; Hyperthyroidism - physiopathology; Infant; Infant, Newborn; Male; Mothers; Neurodevelopmental Disorders - etiology; Pregnancy; Pregnancy Complications - physiopathology; Research Article; Retrospective Studies; Neurodevelopment; Neonatal hyperthyroidism; Behavior; Graves’ disease; Executive functioning; Socioeconomic factors
• ISSN: 1663-2818; 1663-2826
• DOI: 10.1159/000539268

AbstractIntroduction: Neonatal hyperthyroidism, often caused by maternal Graves’ disease (GD), carries potential neurodevelopmental risks for children. Excessive thyroid hormones during fetal development are linked to neurological issues like ADHD and epilepsy. However, the impact of transient neonatal hyperthyroidism is not well understood. Methods: In a retrospective study at the Royal Children’s Hospital in Melbourne, 21 neonates with hyperthyroidism from mothers with GD were examined. Of these, the parents of 10 children consented to participate; thus, questionnaires assessing executive functions, behavior, and social communication were completed. The outcomes were compared to those of control subjects recruited from the community using standardized tools (BRIEF, SDQ, SCQ). The results were analyzed against socio-demographic factors, maternal, and neonatal health. Results: No significant demographic or clinical differences were found between study participants (n = 10) and non-participants (n = 11). Participants, compared to controls, showed similar family demographics but a higher proportion of control parents had university-level education (p = 0.003). Patients displayed more social (SCQ scores: 12.1 ± 2.5 vs. 6 ± 1.07, p = 0.008) and behavioral difficulties (SDQ scores: 10.2 ± 2.17 vs. 6.14 ± 1.03, p = 0.03), with increased executive function challenges (BRIEF scores indicating problem-solving and self-regulation difficulties). Significant effects of family living situation and partner education level on neurodevelopmental measures were noted, underscoring the influence of socio-demographic factors. Conclusions: These findings suggest neonatal hyperthyroidism might lead to subtle neurodevelopmental variations, with socio-economic elements and family dynamics possibly intensifying these effects. While most children did not show severe impairments, early detection and intervention are recommended. The research emphasizes the necessity for inclusive care approaches that consider socio-economic factors for children affected by neonatal hyperthyroidism. Plain Language SummaryResearchers at the Royal Children’s Hospital in Melbourne studied babies with neonatal hyperthyroidism, a condition that can occur when a mother with Graves’ disease passes on antibodies to her child. These antibodies can cause the baby’s thyroid gland to be overactive. The study was interested in how these babies, when they grow older, might do in areas like behavior, social skills, and problem-solving compared to other children without this condition.The study found that while the children with neonatal hyperthyroidism did not have severe problems, they did have more challenges with social interaction, behavior, and executive functions like problem-solving and self-control. These issues were more noticeable in children from single-parent households or those whose parents had less education. This suggests that family environment and parents’ education might influence these developmental areas.The study could not do face-to-face assessments because of COVID-19, so they used questionnaires filled out by the parents. Even though most children were doing okay, the study suggests that early help and support could be beneficial for children with neonatal hyperthyroidism to ensure they have the best development and quality of life possible.It is also highlighted that when taking care of children with this condition, healthcare providers should think about family and social factors, not just medical treatment. This is because the family and social environment could play a big role in the child’s development. More research is needed to understand this fully, but this study provides a good starting point for improving care for these children.