Supplementary Material for: Neurodevelopmental follow-up of children born to mothers with Graves’ disease and neonatal hyperthyroidism

Introduction: Neonatal hyperthyroidism, often caused by maternal Graves' disease (GD), carries potential neurodevelopmental risks for children. Excessive thyroid hormones during fetal development are linked to neurological issues like ADHD and epilepsy. However, the impact of transient neonatal hyperthyroidism is not well understood.

Methods: In a retrospective study at the Royal Children's Hospital in Melbourne, 21 neonates with hyperthyroidism from mothers with GD were examined. Of these, the parents of 10 children consented to participate; thus, questionnaires assessing executive functions, behavior, and social communication were completed. The outcomes were compared to those of control subjects recruited from the community using standardized tools (BRIEF, SDQ, SCQ). The results were analyzed against socio-demographic factors, maternal, and neonatal health.

Results: No significant demographic or clinical differences were found between study participants (n=10) and non-participants (n=11). Participants, compared to controls, showed similar family demographics but a higher proportion of control parents had university-level education (p=0.003). Patients displayed more social (SCQ scores: 12.1±2.5 vs. 6±1.07, p=0.008) and behavioral difficulties (SDQ scores: 10.2±2.17 vs. 6.14±1.03, p=0.03), with increased executive function challenges (BRIEF scores indicating problem-solving and self-regulation difficulties). Significant effects of family living situation and partner education level on neurodevelopmental measures were noted, underscoring the influence of socio-demographic factors.

Conclusions: These findings suggest neonatal hyperthyroidism might lead to subtle neurodevelopmental variations, with socio-economic elements and family dynamics possibly intensifying these effects. While most children didn't show severe impairments, early detection and intervention are recommended. The research emphasizes the necessity for inclusive care approaches that consider socio-economic factors for children affected by neonatal hyperthyroidism.