Faculty

Susana P. Padilla Campos

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Newborns of mothers with thyroid disorders – Outcome and management?

Maternal thyroid adaptation to pregnancy, the placental enzymatic regulation of passage of thyroid hormones, and the ontogeny and physiology of the fetal hypothalamic-pituitary-thyroid axis will be reviewed.

Maternal gestational hypothyroidism and hyperthyroidism, both overt and subclinical, are common during pregnancy with collective incidence variously reported to range from 10% to 30%. That maternal gestational hypothyroxinemia results in impaired neurodevelopmental outcome of the newborn, is well recognized. The impact of maternal iodine deficiency on neonatal thyroid function will be highlighted. Maternal gestational hyperthyroxinemia on the other hand, is associated with increased risk for prematurity, low birth weight and small for gestational age newborns. It is imperative therefore that maternal thyroid disorders be evaluated, diagnosed and treated prior to pregnancy, with adjustments in needed medications to maintain a maternal euthyroid state throughout gestation.

The importance of close coordination and cooperation with our colleagues in Obstetrics, to ensure careful and continued assessment of maternal gestational thyroid status, to avert preventable adverse outcomes of maternal hypothyroidism and hyperthyroidism in the newborn, can not be over-emphasized.

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