Transient neonatal hypothyroidism after gestational exposure to amiodarone: A follow-up of two cases

Amiodarone (AMD) is an antiarrhythmic drug which contains 37% of iodine. It can reach the fetus by transplacental passage and induce fetal hypothyroid ism. Since in some pregnant women AMD represents a cardinal therapeutic opp ortunity, it is necessary to establish not only the risk of teratogenicity linked to fetal AMD exposure but also to evaluate the psychomotor developme nt of children with neonatal thyroid dysfunction related to fetal AMD expos ure. We report on two cases involving children with an AMD gestational expo sure and transient neonatal hypothyroidism, who were followed-up until the age of 4 years 8 months and 5 years 6 months, respectively. Denver's develo pmental milestone test and Whechsler Preschool and Primary Scale of Intelli gence (WPPSI) were administered to the patients in accordance to their age. A normal psychomotor development was observed in both patients with full s cale IQ score, verbal and performance IQ scores within normal range. In con clusion, if these data were validated by larger studies, it might not be ob ligatory to discontinue AMD administration in cardiopathic pregnant women, since mental impairment may not necessarily occur in children with transien t neonatal hypothyroidism caused by fetal AMD exposure. However, the evalua tion of the thyroid function of these children is imperative. (J. Endocrino l. Invest. 21: 699-702, 1998) (C)1998, Editrice Kurtis.