[Ski]

#1074367

My understanding is that antibodies do not affect a growing fetus, they are not passed on. The thing that is passed on to your child is the genetic predisposition to autoimmune diseases in general.

[Bobbi]

#1074368

Actually, there is a rare occurrance possible of fetal/neonatal hyperthyroidism when the mother has Graves, and it is due, as I understand things, to the transplacental transfer of the mother’s antibodies into the baby’s blood. The baby does not "have" Graves, because he/she is not producing the antithyroid immunoglobulins (sp?) itself. So once they have been filtered out of the baby’s body the baby’s thyroid function returns to normal.

[nfinner]

#1074369

I guess I’m worried about wether or not to get my level checked. Is it important?

[Ski]

#1074370

More important to test the baby’s blood for antibodies soon after birth to make sure that the baby does not need to go through the "filtering" process. Your levels are not the determinant as to whether the baby is affected.

[elf]

#1074371

It is always good to check TSI levels before getting pregnant. There are reports on the Internet of thyroid antibodies causing neonatal hyperthyroidism (in women with either active Graves disease or treated).

The neonatal hyperthyroidism seems to resolve or is helped with PTU within weeks or months, in those reports.

The bigger question to ask is – would you wat to have a child if you know that you may pass pre-diposition for a certain disease? For many mothers who have auto-immune diseases, or epilepsy, or other health concerns, the wish of having a child outweighs the odds of passing the disease.

And to add, if a case made its way to a medical report, it means the case was something out of the ordinary, something new for Drs to be educated about. The reports may be viewed from a different angle – the majority of Graves mothers have healthy babies.

[nfinner]

#1019832

I was wondering if it is possible to have the antibodies cross the placenta and affect the baby after being treated with RAI for graves. My endo never checked my level and seemed like it was unimportant but i am paranoid. Any insight?

[LaurelM]

#1074372

With my second pregnancy, I had the same questions.

I was told that while higher TSI levels could indicate a higher risk of neonatal Graves (a very temporary and treatable condition – the baby does not actually have Grave’s disease in the traditional sense, but rather a temporary elevation of thyroid homone) it wasn’t good enough to say anything definitive. Regular fetal monitoring (checking for appropriate growth, no goiter, heartrate) were better indicators of any issues. We decided that since we would have to determine after birth anyway if it appeared that there were any issues that testing the TSI wasn’t something we would do. I can understand someone wanting to make a different decision or getting different advice from their doctor based on their situation.

They would also watch the baby closely after birth and for the first 3 months after birth or so, we wanted to be extra vigiliant for anything that seemed not quite right. For mothers with controlled thyroid levels (I was on PTU when I got pregnant and then tapered off 2 months into the pregnancy) there were very very very low risks to the baby.

Granted, there are very rare instances where there are issues but when I discussed my concerns with my Endo and my high-risk OB they were both very reassuring that they expected a normal pregnancy. I was referred to the high risk OB by my family doctor who delivered my firstborn. I had a shoulder dystocia delivery with my first who was an average sized baby so in combination with the GD they just wanted more of a specialist. The irony is that the Dr. did not make it back to the hospital in time for the actual delivery. The nurse did the catch and I don’t even remember pushing. We have all been healthy and happy since. My daughter is now 2.

The takeaway message here is that if your thyroid levels are well controlled and are being closely monitored by the appropriate people, you should be able to have a healthy pregnancy and birth. There are risks but the chance is minimal. My doctors were much more concerned about the ‘ususal’ issues that can happen with a pregnancy than with anything thyroid related.

If you have any questions about my experience I would be happy to answer what I can.

Laurel

[DianneW]

#1074373

In order for the antibodies to cause hyperthyroidism in the fetus, the mother has to have an exceptionally high antibody level. RAI can cause a temporary rise in antibody levels in some patients that is highest in the first six months to a year following the RAI, but in many patients remains slightly elevated even five years later (though not high enough to affect the baby). One of the reasons doctors recommend women wait six months to a year following RAI to become pregnant is to give these antibodies a chance to level out.

So yes, if RAI is recent (within a year) and a woman wants to become pregnant, definitely discuss the question of an antibody test with your endocrinologist and OB/GYN. Although it’s relatively uncommon for a baby to be born hyperthyroid because of the mother’s antibodies, it happens often enough that it’s not a medical rarity. Mostly it occurs when a mother is untreated than when a mother has high antibodies following RAI, so I don’t think anyone needs to worry very much about this happening in that case.

[LaurelM]

#1074374

I think I forgot to mention that women who are considering getting pregnant should have their levels checked before, during, and after pregnancy (up to a year postpartum) regardless of their thyroid disease history. Having the right levels (not too high and not too low) of thyroid during pregnancy, especially during the 1st half of gestation, is critical to the developing the skeletal system, lungs, and brain. The levels of thyroid that you should have also changes over the course of a pregnancy and is another reason for close monitoring. My friend with hypothyroidism had to up her replacement dose for a time during her pregnancy. Ok, I’ll get off my off my soapbox. I have trouble remember I’m not everybody’s mother.

[Author]

Posts