Prediction of fetal Graves’ disease among pregnant women with Graves’ disease who have undergone thyroidectomy or radioactive iodine therapy: A retrospective observational study
Pregnant women with Graves’ disease (GD) who have undergone thyroidectomy or radioactive iodine therapy can have high levels of thyroid-stimulating hormone (TSH) receptor antibodies, which are transferred to the fetus via the placenta, posing a risk for fetal GD. This retrospective observational stu...
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| Format: | Article |
| Language: | English |
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The Japan Endocrine Society
2025-07-01
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| Series: | Endocrine Journal |
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| Online Access: | https://www.jstage.jst.go.jp/article/endocrj/72/7/72_EJ24-0434/_html/-char/en |
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| author | Aiko Hosoda Naoko Arata Nagayoshi Umehara Shiori Sato Akiko Sankoda Yuko Iimura Asako Mito Chie Nagata Seiji Wada Haruna Kawaguchi Masako Waguri Nobuaki Mitsuda Hitoshi Shimano |
| author_facet | Aiko Hosoda Naoko Arata Nagayoshi Umehara Shiori Sato Akiko Sankoda Yuko Iimura Asako Mito Chie Nagata Seiji Wada Haruna Kawaguchi Masako Waguri Nobuaki Mitsuda Hitoshi Shimano |
| author_sort | Aiko Hosoda |
| collection | DOAJ |
| description | Pregnant women with Graves’ disease (GD) who have undergone thyroidectomy or radioactive iodine therapy can have high levels of thyroid-stimulating hormone (TSH) receptor antibodies, which are transferred to the fetus via the placenta, posing a risk for fetal GD. This retrospective observational study, conducted at two high-level perinatal medical centers in Tokyo and Osaka, Japan, aimed to identify predictors of fetal GD in pregnant women with GD who had undergone thyroidectomy or radioactive iodine therapy. In total, 65 women were included, and 79 singleton pregnancies and fetuses were analyzed. Fetal GD occurred in 17.7% of the 79 fetuses. Women in the fetal GD group had higher levels of TSH receptor antibodies and a higher prevalence of ophthalmopathies than did women in the non-fetal GD group. The receiver operating characteristic curve cutoff values of maternal TSH-binding inhibitory immunoglobulin (hereafter referred to as TRAb [TSH receptor antibody from a narrow perspective]) and thyroid-stimulating antibody (TSAb) levels predictive of fetal GD development were as follows: TRAb, 12.8 and 10.2 IU/L at 10 and 20 gestational weeks (GW), respectively; TSAb, 975.4% and 1,259.0% at 10 and 20 GW, respectively. Ophthalmopathy was a predictor of fetal GD; nonetheless, combining the ophthalmopathy and TRAb cutoff values did not improve predictive accuracy. A cutoff value of TRAb ≥10.2 IU/L at 20 GW (highest diagnostic accuracy found) could be a predictor of fetal GD risk for pregnant women with GD who undergo thyroidectomy or radioactive iodine therapy; thus, appropriate fetal monitoring should begin at around 20 GW. |
| format | Article |
| id | doaj-art-bb22c970c4a3408ab7f8af33ee7e0cb9 |
| institution | Kabale University |
| issn | 1348-4540 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | The Japan Endocrine Society |
| record_format | Article |
| series | Endocrine Journal |
| spelling | doaj-art-bb22c970c4a3408ab7f8af33ee7e0cb92025-08-20T03:28:19ZengThe Japan Endocrine SocietyEndocrine Journal1348-45402025-07-0172781982910.1507/endocrj.EJ24-0434endocrjPrediction of fetal Graves’ disease among pregnant women with Graves’ disease who have undergone thyroidectomy or radioactive iodine therapy: A retrospective observational studyAiko Hosoda0Naoko Arata1Nagayoshi Umehara2Shiori Sato3Akiko Sankoda4Yuko Iimura5Asako Mito6Chie Nagata7Seiji Wada8Haruna Kawaguchi9Masako Waguri10Nobuaki Mitsuda11Hitoshi Shimano12Department of Endocrinology and Metabolism, Institute of Medicine, University of Tsukuba, Ibaraki 305-8575, JapanCenter for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo 157-8535, JapanCenter for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo 157-8535, JapanCenter for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo 157-8535, JapanCenter for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo 157-8535, JapanCenter for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo 157-8535, JapanCenter for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo 157-8535, JapanDevelopment of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo 105-8461, JapanCenter for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo 157-8535, JapanDepartment of Maternal Fetal Medicine, Osaka Women’s and Children’s Hospital, Osaka 594-1101, JapanDepartment of Obstetric Medicine, Osaka Women’s and Children’s Hospital, Osaka 594-1101, JapanDepartment of Maternal Fetal Medicine, Osaka Women’s and Children’s Hospital, Osaka 594-1101, JapanDepartment of Endocrinology and Metabolism, Institute of Medicine, University of Tsukuba, Ibaraki 305-8575, JapanPregnant women with Graves’ disease (GD) who have undergone thyroidectomy or radioactive iodine therapy can have high levels of thyroid-stimulating hormone (TSH) receptor antibodies, which are transferred to the fetus via the placenta, posing a risk for fetal GD. This retrospective observational study, conducted at two high-level perinatal medical centers in Tokyo and Osaka, Japan, aimed to identify predictors of fetal GD in pregnant women with GD who had undergone thyroidectomy or radioactive iodine therapy. In total, 65 women were included, and 79 singleton pregnancies and fetuses were analyzed. Fetal GD occurred in 17.7% of the 79 fetuses. Women in the fetal GD group had higher levels of TSH receptor antibodies and a higher prevalence of ophthalmopathies than did women in the non-fetal GD group. The receiver operating characteristic curve cutoff values of maternal TSH-binding inhibitory immunoglobulin (hereafter referred to as TRAb [TSH receptor antibody from a narrow perspective]) and thyroid-stimulating antibody (TSAb) levels predictive of fetal GD development were as follows: TRAb, 12.8 and 10.2 IU/L at 10 and 20 gestational weeks (GW), respectively; TSAb, 975.4% and 1,259.0% at 10 and 20 GW, respectively. Ophthalmopathy was a predictor of fetal GD; nonetheless, combining the ophthalmopathy and TRAb cutoff values did not improve predictive accuracy. A cutoff value of TRAb ≥10.2 IU/L at 20 GW (highest diagnostic accuracy found) could be a predictor of fetal GD risk for pregnant women with GD who undergo thyroidectomy or radioactive iodine therapy; thus, appropriate fetal monitoring should begin at around 20 GW.https://www.jstage.jst.go.jp/article/endocrj/72/7/72_EJ24-0434/_html/-char/engraves’ diseasepregnancyfetal graves’ diseasethyroid-stimulating hormone receptor antibodies |
| spellingShingle | Aiko Hosoda Naoko Arata Nagayoshi Umehara Shiori Sato Akiko Sankoda Yuko Iimura Asako Mito Chie Nagata Seiji Wada Haruna Kawaguchi Masako Waguri Nobuaki Mitsuda Hitoshi Shimano Prediction of fetal Graves’ disease among pregnant women with Graves’ disease who have undergone thyroidectomy or radioactive iodine therapy: A retrospective observational study Endocrine Journal graves’ disease pregnancy fetal graves’ disease thyroid-stimulating hormone receptor antibodies |
| title | Prediction of fetal Graves’ disease among pregnant women with Graves’ disease who have undergone thyroidectomy or radioactive iodine therapy: A retrospective observational study |
| title_full | Prediction of fetal Graves’ disease among pregnant women with Graves’ disease who have undergone thyroidectomy or radioactive iodine therapy: A retrospective observational study |
| title_fullStr | Prediction of fetal Graves’ disease among pregnant women with Graves’ disease who have undergone thyroidectomy or radioactive iodine therapy: A retrospective observational study |
| title_full_unstemmed | Prediction of fetal Graves’ disease among pregnant women with Graves’ disease who have undergone thyroidectomy or radioactive iodine therapy: A retrospective observational study |
| title_short | Prediction of fetal Graves’ disease among pregnant women with Graves’ disease who have undergone thyroidectomy or radioactive iodine therapy: A retrospective observational study |
| title_sort | prediction of fetal graves disease among pregnant women with graves disease who have undergone thyroidectomy or radioactive iodine therapy a retrospective observational study |
| topic | graves’ disease pregnancy fetal graves’ disease thyroid-stimulating hormone receptor antibodies |
| url | https://www.jstage.jst.go.jp/article/endocrj/72/7/72_EJ24-0434/_html/-char/en |
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