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Thyroid function in neonates of women with subclinical hypothyroidism or hypothyroxinemia

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Abstract

Objective

To assess whether treatment of pregnant women with subclinical hypothyroidism or hypothyroxinemia alters neonatal TSH results.

Study design

A planned secondary analysis of data from two multi-center randomized, double-masked, placebo-controlled thyroxine replacement trials in pregnant women with either subclinical hypothyroidism or hypothyroxinemia. Infant heel-stick specimens were obtained before discharge. We compared TSH levels between neonates born to mothers allocated to treatment or placebo within each trial and between neonates in the placebo groups. Multiples of means were generated for day-of-life-specific data.

Results

Neonatal TSH values were available for 573/677 (84.6%) newborns from the subclinical hypothyroidism trial and 461/526 (87.6%) newborns from the hypothyroxinemia trial. Neonatal TSH values did not differ in either trial by treatment group or between placebo groups (P > 0.05 for all comparisons).

Conclusions

Neonatal TSH values did not differ with thyroid hormone replacement in pregnancies diagnosed with subclinical hypothyroidism or hypothyroxinemia.

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Acknowledgements

We thank Lisa Moseley, R.N., B.S.N., and Gail Mallet, R.N., B.S.N., C.C.R.C., for protocol development and coordination between clinical research centers; Barbara Jones-Binns, J.D., M.P.H., for protocol and data management, overall coordination, and quality control; and Elizabeth A. Thom, Ph.D., Deborah G. Hirtz, M.D., and Catherine Y. Spong, M.D. for protocol development and oversight.

In addition to the authors, other members of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network are as follows:

The University of Utah Health Sciences Center, Salt Lake City, UT – K. Hill, A. Sowles, S. Timothy, P. Reed (Intermountain Healthcare), S. Esplin (Intermountain Healthcare).

University of Texas Southwestern Medical Center, Dallas, TX – L. Moseley, J. Price, C. Melton, M. Garcia, J. Gerald, M. Santillan.

University of Pittsburgh, Pittsburgh, PA – M. Cotroneo, D. DeAngelis, M. Luce, R. Kennedy, D. Nowinski.

University of Alabama at Birmingham, Birmingham, AL – S. Harris, F. Biasini, M. Parks, J. Grant, C. Lee, A. Todd, K. Domnanovich, W. Andrews.

Wayne State University, Detroit, MI – N. Hauff, L. Goldston, D. Driscoll.

The Ohio State University, Columbus, OH – F. Johnson, S. Wylie, R. Devlin, B. Selegue, C. Latimer, J. Bauer.

Brown University, Providence, Rhode Island – D. Allard, T. Leach, V. Watson, B. Hughes.

Columbia University, New York, NY – S. Bousleiman, V. Carmona, A. Zygmunt, Y. Williams (Drexel University), M. Grant (Drexel University), C. Kitto (Christiana Care Health Systems), B. Higley (Christiana Care Health Systems), M. Falk (St. Peter’s University Hospital); L. Padovano (St. Peter’s University Hospital).

University of Texas Medical Branch, Galveston, TX – A. Salazar, A. Acosta, K. Smith, G. Hankins, S. Jain, M. Munn, L. Pacheco.

MetroHealth Medical Center-Case Western Reserve University, Cleveland, OH – C. Milluzzi, B. Nielsen, W. Dalton, H. Cozart, E. Chien.

The University of Texas Health Science Center at Houston, McGovern Medical School-Children’s Memorial Hermann Hospital, Houston, TX – F. Ortiz, S. Blackwell, B. Rech, M. Hutchinson, P. Givens.

University of North Carolina at Chapel Hill, Chapel Hill, NC – K. Clark, S. Timlin, K. Dorman, E. Campos, H. Byers, S. Brody (WakeMed Health & Hospitals).

Northwestern University, Chicago, IL – G. Mallett, M. Ramos-Brinson, M. Weissbourd (Lurie Children’s Hospital), M. Dinsmoor (NorthShore University HealthSystem), K. Paychek (NorthShore University HealthSystem), P. Campbell.

Oregon Health & Science University, Portland, OR – M. Rincon, L. Pereira, P. Blasco, S. Saxton, K. Beach, J. Snyder.

George Washington University Biostatistics Center, Washington, DC – E.A. Thom, B. Jones-Binns.

National Institute of Neurological Disorders and Stroke, Bethesda, MD – D.G. Hirtz

Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD – C. Spong, S. Tolivaisa.

MFMU Network Steering Committee Chair (Medical University of South Carolina, Charleston, SC) – J. P. VanDorsten, M.D.

Funding

Supported by grants (HD34116, HD40512, HD27917, HD34208, HD40485, HD40560, HD53097, HD27869, HD40500, HD40545, HD27915, HD40544, HD53118, HD21410, and HD36801) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Neurological Disorders and Stroke.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology of the University of Utah Health Sciences Center, Salt Lake City, UT, USA

    Michael W. Varner

  2. The George Washington University Biostatistics Center, Washington, DC, USA

    Lisa Mele

  3. University of Texas - Southwestern, Dallas, TX, USA

    Brian M. Casey

  4. Northwestern University, Chicago, IL, USA

    Alan M. Peaceman

  5. Wayne State University, Detroit, MI, USA

    Yoram Sorokin

  6. The Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA

    Uma M. Reddy

  7. Columbia University, New York, NY, USA

    Ronald J. Wapner

  8. University of North Carolina, Chapel Hill, NC, USA

    John M. Thorp

  9. University of Texas Medical Branch, Galveston, TX, USA

    George R. Saade

  10. University of Alabama at Birmingham, Birmingham, AL, USA

    Alan T. N. Tita

  11. Brown University, Providence, RI, USA

    Dwight J. Rouse

  12. University of Texas – Houston, Houston, TX, USA

    Baha Sibai

  13. The Ohio State University, Columbus, OH, USA

    Jay D. Iams

  14. Case Western Reserve University, Cleveland, OH, USA

    Brian M. Mercer

  15. Oregon Health Sciences University, Portland, OR, USA

    Jorge Tolosa

  16. University of Pittsburgh, Pittsburgh, PA, USA

    Steve N. Caritis

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  1. Michael W. Varner
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  2. Lisa Mele
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for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network

Corresponding author

Correspondence to Michael W. Varner.

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The authors declare that they have no conflict of interest.

Additional information

The other members of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network are listed in the Acknowledgements.

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Varner, M.W., Mele, L., Casey, B.M. et al. Thyroid function in neonates of women with subclinical hypothyroidism or hypothyroxinemia. J Perinatol 38, 1490–1495 (2018). https://doi.org/10.1038/s41372-018-0213-9

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