Abstract：
Background: Graves\' disease has been associated with adverse pregnancy, labor and delivery, and neonatal outcomes. Thyroid function levels, assessed during newborn screening (NBS), can serve as indicators of the adaptation in the hypothalamic-pituitary-thyroid axis. We utilized data from the national thyroid NBS program to investigate the characteristics of the mother-infant dyad of term infants born to mothers with past or active Graves\' disease. Methods: The dataset of the Israeli NBS for thyroid function was linked with the electronic records of a tertiary medical center to generate a unified database of mothers and their term infants born between 2011 and 2021. The MDClone big data platform extracted maternal, pregnancy, disease course, labor and delivery, and neonatal characteristics of the mother-infant dyads. Results: Out of 103,899 registered mother-infant dyads, 292 (0.3%) mothers had past or active Graves\' disease. A forward multivariate linear regression demonstrated that Graves\' disease did not significantly affect NBS total thyroxine (tT4) levels (p = 0.252). NBS tT4 levels in infants born to mothers with active Graves\' disease were higher than those observed in the general Israeli population (p < 0.001). Mothers with Graves\' disease more frequently used assisted reproductive technology (12.7% vs. 9.0%, respectively, p = 0.012; odds ratio [OR] = 1.46 [CI 1.03-2.07], p = 0.031), and had more gestational hypertension (3.9% vs. 1.1%, p < 0.001; OR = 3.53 [CI 1.92-6.47], p < 0.001), proteinuria (2.5% vs. 0.9%, p < 0.001; OR = 3.03 [CI 1.43-6.45], p = 0.004), cesarean sections (26.4% vs. 19.7%, p = 0.029; OR = 1.46 [CI 1.13-1.90], p = 0.004), prelabor rupture of membranes (15.4% vs. 4.1%, p < 0.001; OR = 4.3 [CI 3.13-5.91], p < 0.001), and placental abnormalities (5.1% vs. 2.0%, p < 0.001; OR = 2.64 [CI 1.57-4.44]; p < 0.001). Their infants had lower adjusted birthweight z-scores (-0.18 ± 0.94 vs. -0.03 ± 0.90, p = 0.007) and were more likely to be small for gestational age (12.0% vs. 8.1%, p = 0.005; OR = 1.54 [CI 1.08-2.19], p = 0.018). Conclusions: Neonatal thyroid function levels were affected by maternal Graves\' disease only when the disease was active during gestation. Moreover, maternal Graves\' disease was also associated with an increased risk of adverse outcomes for the mother-infant dyad.
摘要：
背景：格雷夫斯病与不良妊娠有关，人工和交付，和新生儿结局。甲状腺功能水平,在新生儿筛查（NBS）期间评估，可以作为下丘脑-垂体-甲状腺轴适应的指标。我们利用来自国家甲状腺NBS计划的数据来调查患有过去或活动性Graves病的母亲所生的足月婴儿的母婴二联的特征。
方法：将以色列NBS的甲状腺功能数据集与三级医疗中心的电子记录相关联，以生成2011年至2021年出生的母亲及其足月婴儿的统一数据库。MDClone大数据平台提取了母体，怀孕,病程,人工和交付，和母婴二叉的新生儿特征。
结果：在103,899个登记的母婴二叉中，292名（0.3%）母亲患有过去或活动性格雷夫斯病。正向多元线性回归表明Graves病对NBS总甲状腺素(TT4)水平无显著影响(p=0.252)。患有活动性Graves病的母亲所生婴儿的NBSTT4水平高于一般以色列人群(p<0.001)。患有格雷夫斯病的母亲更经常使用辅助生殖技术(12.7%vs9.0%，分别,p=0.012；优势比[OR]1.46[95%置信区间[CI]1.03-2.07]，p=0.031),并且有更多的妊娠期高血压(3.9%vs1.1%，p<0.001；OR3.53[95CI1.92-6.47]，p<0.001)，蛋白尿（2.5%对0.9%，p<0.001；OR3.03[95%CI1.43-6.45]，p=0.004),剖宫产（26.4%vs19.7%，p=0.029；或1.46[95CI1.13-1.90]，p=0.004),胎膜前破裂(15.4%vs4.1%，p<0.001；OR4.3[95CI3.13-5.91]，p<0.001)，和胎盘异常(5.1%vs2.0%，p<0.001；OR2.64[95CI1.57-4.44]；p<0.001)。他们的婴儿的调整出生体重z评分较低（-0.18±0.94vs-0.03±0.90，p=0.007），并且更可能小于胎龄（12.0％vs8.1％，p=0.005；OR1.54[95CI1.08-2.19]，p=0.018)。
结论：新生儿甲状腺功能水平仅在妊娠期间疾病活跃时受到母体Graves病的影响。此外，孕产妇Graves病也与母婴二联的不良结局风险增加相关.
方法：将以色列NBS的甲状腺功能数据集与三级医疗中心的电子记录相关联，以生成2011年至2021年出生的母亲及其足月婴儿的统一数据库。MDClone大数据平台提取了母体，怀孕,病程,人工和交付，和母婴二叉的新生儿特征。
结果：在103,899个登记的母婴二叉中，292名（0.3%）母亲患有过去或活动性格雷夫斯病。正向多元线性回归表明Graves病对NBS总甲状腺素(TT4)水平无显著影响(p=0.252)。患有活动性Graves病的母亲所生婴儿的NBSTT4水平高于一般以色列人群(p<0.001)。患有格雷夫斯病的母亲更经常使用辅助生殖技术(12.7%vs9.0%，分别,p=0.012；优势比[OR]1.46[95%置信区间[CI]1.03-2.07]，p=0.031),并且有更多的妊娠期高血压(3.9%vs1.1%，p<0.001；OR3.53[95CI1.92-6.47]，p<0.001)，蛋白尿（2.5%对0.9%，p<0.001；OR3.03[95%CI1.43-6.45]，p=0.004),剖宫产（26.4%vs19.7%，p=0.029；或1.46[95CI1.13-1.90]，p=0.004),胎膜前破裂(15.4%vs4.1%，p<0.001；OR4.3[95CI3.13-5.91]，p<0.001)，和胎盘异常(5.1%vs2.0%，p<0.001；OR2.64[95CI1.57-4.44]；p<0.001)。他们的婴儿的调整出生体重z评分较低（-0.18±0.94vs-0.03±0.90，p=0.007），并且更可能小于胎龄（12.0％vs8.1％，p=0.005；OR1.54[95CI1.08-2.19]，p=0.018)。
结论：新生儿甲状腺功能水平仅在妊娠期间疾病活跃时受到母体Graves病的影响。此外，孕产妇Graves病也与母婴二联的不良结局风险增加相关.
