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CC BY-NC-ND 4.0 · Journal of Fetal Medicine 2022; 09(01): 13-16
DOI: 10.1007/s40556-022-00337-7
Case Reports

Maternal Levothyroxine Treatment as an Etiologic Factor in the Development of Infantile Craniosynostosis

Brandon R. Block
1   University of Pennsylvania, Philadelphia, PA, USA
2   New Jersey Pediatric Neuroscience Institute, 131 Madison Ave 3rd Floor, 07960, Morristown, NJ, USA
,
John J. Collins
2   New Jersey Pediatric Neuroscience Institute, 131 Madison Ave 3rd Floor, 07960, Morristown, NJ, USA
,
Jose C. Rios
3   Department of Radiology, Morristown Medical Center, Morristown, NJ, USA
,
Catherine A. Mazzola
2   New Jersey Pediatric Neuroscience Institute, 131 Madison Ave 3rd Floor, 07960, Morristown, NJ, USA
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Abstract

Craniosynostosis (CS) is a condition characterized by premature fusion of one or more calvarial sutures. Numerous studies have demonstrated a correlation between CS and maternal hypothyroidism (MH), but research into this relationship has been scarce. A six-day-old male patient presented for initial neurosurgical consultation with trigonocephaly and prominent metopic ridging. A CT scan of the head confirmed the diagnosis of metopic CS, and it was revealed during the examination that the mother suffered from hypothyroidism during her pregnancy. Two theories provide a potential etiologic basis for the development of CS in infants born to hypothyroid mothers treated with levothyroxine. It is possible that the transplacental delivery of levothyroxine results in fetal thyrotoxicosis. Alternatively, intermittent periods of maternal hypothyroxinemia may encourage fetal thyroid hyperactivity to compensate for insufficient maternal thyroid hormones. Regardless, both theories must be formally investigated in order to elucidate the true association between CS and MH.

Keywords

Craniosynostosis - Maternal hypothyroidism - Levothyroxine - Fetal thyrotoxicosis - Hypothyroxinemia


Publication History

Received: 31 October 2021

Accepted: 24 January 2022

Article published online:
04 May 2023

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