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Hemodynamic changes in neonates born to mothers with Graves’ disease

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Abstract

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 (FT3), free thyroxine (FT4), 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 FT4 levels and CI on Day 5 (both p < 0.05) and higher FT3 (p < 0.05) and FT4 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.

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Availability of data and material

The datasets during and/or analyzed during the current study available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank Dr. Masaki Yamamoto, Department of Pediatrics, Seirei Hamamatsu General Hospital, Dr. Shinichi Nakashima, JA Shizuoka Kohseiren Enhu Hospital, and Dr. Jiro Kagawa, Fujieda Municipal General Hospital, for their valuable assistance.

Author contributions

TI designed and conducted the research, conducted the statistical analyses, interpreted the data, and drafted the initial manuscript. HU, SI, TB, and AO made substantial contributions to the acquisition of data. SI and HI contributed to the study design and provided comments on the manuscript. All authors revised and approved the final version.

Funding

This work was supported by JSPS KAKENHI Grant Number JP18K07787.

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Authors and Affiliations

  1. Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan

    Takamichi Ishikawa, Hiroki Uchiyama, Satoru Iwashima, Toru Baba, Akira Ohishi & Shigeo Iijima

  2. Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Shizuoka, Japan

    Hiroaki Itoh

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  1. Takamichi Ishikawa
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Correspondence to Takamichi Ishikawa.

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Informed consent was obtained from the parents of each newborn.

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The study was conducted in accordance with the ethical principles described in the Declaration of Helsinki and was approved by the local ethics committees.

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Ishikawa, T., Uchiyama, H., Iwashima, S. et al. Hemodynamic changes in neonates born to mothers with Graves’ disease. Endocrine 72, 171–178 (2021). https://doi.org/10.1007/s12020-020-02443-w

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