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Graves Disease in a Newborn (Neonatal Graves Disease)

What is Graves disease?

Graves disease is an autoimmune disease. The immune system normally protects the body from germs with chemicals called antibodies. But with an autoimmune disease, it makes antibodies that attack the body’s own tissues. With Graves disease, antibodies cause the thyroid gland to make too much thyroid hormone. This is known as hyperthyroidism. Extra thyroid hormone in the bloodstream leads to the body's metabolism being too active. It can cause problems such as low weight, fast heartbeat, high blood pressure, and heart failure.

Graves disease occurs more often in children. But it can also occur in newborn babies. If not diagnosed shortly after birth, Graves disease can be fatal to a newborn baby.

What causes Graves disease in a newborn?

raves disease in a newborn occurs when the mother has or had Graves disease. The mother’s antibodies can cross the placenta and affect the thyroid gland in the growing baby. Graves disease in a pregnant woman can result in stillbirth, miscarriage, or preterm birth.

Who is at risk for Graves disease in a newborn?

The biggest risk factor for Graves disease in a newborn is when the mother has or had Graves disease. But not all newborns born to mothers with Graves disease will have the disorder.

What are the symptoms of Graves disease in a newborn?

Signs can occur a bit differently in each baby. They can include:

  • Low birth weight
  • Small or abnormally shaped head
  • Poor weight gain (failure to thrive)
  • Enlarged liver and spleen
  • Swelling of the front of the neck due to large thyroid (goiter)
  • Fast heartbeat, which can lead to heart failure
  • High blood pressure
  • Nervousness
  • Irritability
  • Trouble sleeping
  • Bulging eyes
  • Vomiting
  • Diarrhea
  • Trouble breathing if a goiter is pressing on the windpipe

The signs of Graves disease can be like other health conditions. Make sure your baby sees his or her healthcare provider for a diagnosis.

How is Graves disease in a newborn diagnosed?

If not diagnosed shortly after birth, Graves disease can be fatal to a newborn baby. The healthcare provider will ask about your baby’s signs and health history. He or she may also ask about the birth mother’s health history. He or she will give your baby a physical exam. Your baby may also have a blood test to check the level of thyroid hormone.       

How is Graves disease in a newborn treated?

With treatment right away, babies usually recover fully within a few weeks. But Graves disease may recur during the first 6 months to 1 year of life. The goal of treatment is to restore the thyroid gland to normal function so it makes normal levels of thyroid hormone.

Treatment may include:

  • Medicine that blocks the production of thyroid hormones and treats rapid heart rate
  • Treatment for heart failure

What are possible complications of Graves disease in a newborn?

Untreated Graves disease in a newborn can be fatal. It can also cause:

  • Early closing of bones in the skull
  • Intellectual disability
  • Hyperactivity
  • Fast growth that slows and then stops early, leading to short height

Can Graves disease in a newborn be prevented?

There is no known way to prevent the disorder. Even women who are cured of Graves disease by ablation of the thyroid gland are still at risk for babies with neonatal Graves disease.

How to manage Graves disease in a newborn

A pregnant woman who had or has Graves disease needs to tell her healthcare provider. This is so her baby can be checked at birth and treated right away if needed. With treatment right away, babies usually recover fully within a few weeks. But Graves disease may recur during the first 6 months to 1 year of life. It’s important to watch your baby ongoing for signs of Graves disease.

When should I call my child's healthcare provider?

Call your baby’s healthcare provider if you think your baby has signs of Graves disease.

Key points about Graves disease in a newborn

  • Graves disease is an autoimmune disease. With Graves disease, antibodies cause the thyroid gland to make too much thyroid hormone. This is known as hyperthyroidism.
  • Excess thyroid hormone in the bloodstream leads to the body's metabolism being too active. It can cause problems such as low weight, fast heartbeat, high blood pressure, heart failure, and other issues.
  • Graves disease in a newborn occurs when the mother has or had Graves disease. It can result in stillbirth, miscarriage, or preterm birth.
  • If not diagnosed shortly after birth, Graves disease can be fatal to a newborn baby.
  • With treatment right away, babies usually recover fully within a few weeks. However, Graves disease may recur during the first 6 months to 1 year of life.
  • Treatment may include medicine and other treatment.
  • A pregnant woman who had or has Graves disease needs to tell her healthcare provider. This is so their baby can be checked at birth and treated right away if needed.

Next steps

Tips to help you get the most from a visit to your child’s health care provider:
  • Before your visit, write down questions you want answered.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you for your child.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.
Online Medical Reviewer: Berry, Judith, PhD, APRN
Online Medical Reviewer: Freeborn, Donna, PhD, CNM, FNP
Date Last Reviewed: 9/10/2015
© 2000-2016 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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