Does maternal antepartum hypothyroidism cause fetal and neonatal hyponatremia?

What is it about?

The activities of maternal thyroid hormones (THs) are important for the advancement of the prenatal and postnatal development. The homeostasis between the levels of THs and the placental development regulates the electrolytes equilibrium between dams and their fetuses/newborns. On the other hand, hyponatremia, electrolyte abnormality, can cause by the excess free H2O intake and the impairment in its excretion due to arginine vasopressin (AVP) excess. Another probable cause of hyponatremia is hypothyroidism/myxedema. More importantly, possible mechanisms of hyponatremia associated with hypothyroidism can be explained as the following: (1) increased the syndrome of inappropriate antidiuretic hormone secretion (SIADH; increase urine Na+); (2) decreased the cardiac outputs; (3) increased the level of antidiuretic hormone (ADH); (4) salt-losing nephropathy and hypovolemia; (5) decreased the glomerular filtration rate (GFR); (6) low-iodine and solute intake; (7) decreased the water delivery to the kidney diluting segment; (8) decreased the excretion of water content; and (9) water retention. In addition, any disruption in the activities of maternal antepartum THs (hypothyroidism) may disturb the electrolyte equilibrium between the dams and their fetuses/neonates. My hypothesis is the maternal antepartum dyselectrolytemia may intensify the risk of pre-delivery and may cause neonatal disorders. Though, the mechanism of maternofetal dyselectrolytemia or metabolic derangement remains indeterminate. Thus, I advise to treat the maternal electrolyte imbalance and thyroid functions before the gestation or correct the dyselectrolytemia and thyroid functions in the neonates after the labor. Moreover, a care postpartum for both dams and their newborns may be required to get a good outcome.

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Why is it important?

My hypothesis is the maternal antepartum dyselectrolytemia may intensify the risk of pre-delivery and may cause neonatal disorders.

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