Maternal TRAb – neonatal risk — RACP Paediatrics MCQ

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ModerateEndocrineMaternal TRAb – neonatal riskRACP Paediatrics

A pregnant woman with current Graves disease has high TRAb levels at 36 weeks. What investigation should be planned for the neonate?

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Correct answer: C — Maternal Graves disease – check TRAb

Maternal TRAb levels should be checked in the third trimester in all pregnant women with current or past Graves disease. High TRAb levels (>3× upper limit of normal) indicate risk of neonatal thyrotoxicosis. The neonate should have TFTs checked at day 3-5 (delayed presentation is possible if maternal carbimazole was masking fetal thyrotoxicosis). Neonatal monitoring for thyrotoxicosis should continue for 2-3 months.

Reference: RCH Melbourne – 2023 – Neonatal Thyroid CPG; RACP Paediatric Curriculum – Endocrine