Hemodynamic changes in neonates born to mothers with Graves’ disease

• Published in: Endocrine Vol. 72; no. 1; pp. 171 - 178
• Main Authors: Ishikawa, Takamichi, Uchiyama, Hiroki, Iwashima, Satoru, Baba, Toru, Ohishi, Akira, Iijima, Shigeo, Itoh, Hiroaki
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.04.2021; Springer Nature B.V
• Subjects: Brain natriuretic peptide; Coronary artery disease; Diabetes; Echocardiography; Endocrinology; Graves' disease; Heart diseases; Hemodynamics; Humanities and Social Sciences; Hyperthyroidism; Internal Medicine; Medicine; Medicine & Public Health; Morbidity; Mothers; multidisciplinary; Neonates; Original Article; Science; Serum levels; Thyroid hormones; Thyroid-stimulating hormone; Thyroxine; Triiodothyronine; Neonatal hyperthyroidism; Echocardiography; Cardiac output; Thyroid-stimulating hormone receptor antibody; N-terminal-pro-B-type natriuretic peptide
• ISSN: 1355-008X; 1559-0100
• DOI: 10.1007/s12020-020-02443-w

Purpose Cardiac insufficiency is a major morbidity in neonatal hyperthyroidism. It is important to assess the hemodynamics in neonates born to mothers with Graves’ disease (GD). This study prospectively evaluated the hemodynamic changes in neonates born to mothers with GD. Methods Overall, 80 newborns were enrolled. Thirty-six neonates were born to mothers with GD who were positive for thyroid-stimulating hormone (TSH) receptor antibody (TRAb), and 44 were born to mother negative for TRAb. The serum levels of TSH, free triiodothyronine (FT 3 ), free thyroxine (FT 4 ), and N-terminal-pro-B-type natriuretic peptide (NT-proBNP), the cardiac output, and cardiac index (CI) evaluated by echocardiography were compared between the two groups at several postnatal points (day of delivery and 5, 10, and 30 days of life). Results The TRAb-positive newborns had higher FT 4 levels and CI on Day 5 (both p  < 0.05) and higher FT 3 ( p  < 0.05) and FT 4 levels ( p  < 0.01) and CI ( p  < 0.01) but lower TSH levels ( p  < 0.05) on Day 10 than the TRAb-negative newborns. The TRAb-positive newborns had significantly higher NT-proBNP levels on Days 5 (median 752 vs. 563 pg/mL, p  = 0.034) and 10 (median 789 vs. 552 pg/mL, p  = 0.002) than the TRAb-negative newborns. Conclusions Hemodynamic changes in neonates born to TRAb-positive mothers with GD resulted in a higher CI and NT-proBNP levels than in those with TRAb-negative mothers from postnatal days 5 to 10.