STUDY OF MATERNAL RISK FACTORS CONTRIBUTING IN THE DEVELOPMENT OF CONGENITAL HYPOTHYROIDISM

Abstract

ABSTRACT
Background: The study was conducted to assess maternal factors contributing in the development of congenital hypothyroidism (CH) in their neonates whom were diagnosed by public health insurance newborn screening program during study period from January to December 2017 in Sharkia governorate.
Methods: The study had been conducted on selected sample of 50 mothers; they are selected according to their neonates' thyroid profile and divided into two groups: Group 1 (cases): selected 25 mothers having neonates diagnosed with CH. Group 2 (control): selected 25 healthy neonates and their mothers. All mothers in our study were subjected to full history assessment, physical exam and specific laboratory testing including (TSH, Free T4, Free T3, Anti TPO and Anti TG). On other hand, baseline characteristics and screening laboratory results of neonates diagnosed with CH were obtained from their registered profiles in public health insurance organization in Sharkia governorate.
Results: Clinical parameters of mothers included revealed that mothers having previous history of thyroid disorders as well as maternal abortion rates were higher in case group compared to control group and this difference was statistically significant. Clinical and demographic results of neonates diagnosed with CH, showed that neonatal birth weight was lower in case group compared to control group and this difference was statistically significant. The presence of maternal thyroid dysfunction (mainly hypothyroidism) was higher in case group compared to control group and this difference was statistically significant. Maternal auto-thyroid antibodies (Anti TPO and Anti TG) were higher in case group compared to control group and this difference was statistically significant.
Conclusions: Maternal risk factors in our study contributing in the development of CH were highly related to the presence of maternal thyroid disorders either controlled on treatment or not. As well as, thyroid laboratory dysfunction (mainly sub/hypothyroidism) in mothers induced mostly by autoimmune thyroid state confirmed by presence of higher levels of auto-thyroid antibodies (Anti TPO and Anti TG) which proved to be significant and these autoimmune antibodies in its turn increase the rates of maternal miscarriage, neonatal prematurity and low birth weight as reported in our study.
Abbreviations: CH= congenital hypothyroidism, TSH= Thyroid Stimulating Hormone, Anti TPO= anti thyroid peroxidase antibodies, Anti TG= anti thyroglobulin antibodies.
Key words: congenital hypothyroidism, maternal, autoimmune thyroid.