Supplementary Data. Description of Literature Search. thyrotropin-binding inhibitory immunoglobulin [Supplementary Concept]

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1 Supplementary Data Description of Literature Search thyrotropin-binding inhibitory immunoglobulin [Supplementary Concept] AND Fetus [Mesh]) AND Thyrotoxicosis [Mesh] OR OR thyroid binding inhibitory immunoglobulin* [tiab] OR TBII [tiab] OR TSH receptor antibod* [tiab] OR thyroid stimulating hormone receptor antibod* [tiab] OR TRAb [tiab] OR TSHR autoantibod* [tiab] OR TSHR antibod* [tiab] OR thyroid stimulating antibod* [tiab] OR TSAb [tiab] OR thyroid stimulating immunoglobulin* [tiab] OR TSI [tiab] OR long acting thyroid stimula* [tiab] OR LATS [tiab] OR thyroid receptor antibod* [tiab] OR thyroid receptor immunoglobulin* [tiab] OR thyroid hormone receptor antibod* [tiab] OR thyroid hormone receptor immunoglobulin* [tiab] OR TSH binding inhibitory immunoglobulin* [tiab] OR thyroid stimulating hormone binding inhibitory immunoglobulin* [tiab] OR thyrotrophin receptor antibod* [tiab] OR TSH stimulating antibod* [tiab] fetal thyrotoxicosis [tiab] OR fetal glandular dis* [tiab] OR fetal graves [tiab] OR fetal graves dis* [tiab] OR fetal hyperthyroidism [tiab] OR neonatal thyrotoxicosis [tiab] OR neonatal glandular dis* [tiab] OR neonatal graves [tiab] OR neonatal graves dis* [tiab] OR neonatal hyperthyroidism [tiab] OR newborn thyrotoxicosis [tiab] OR newborn glandular dis* [tiab] OR newborn graves [tiab] OR newborn graves dis* [tiab] OR newborn hyperthyroidism [tiab] OR infant thyrotoxicosis [tiab] OR infant glandular dis* [tiab] OR infant graves [tiab] OR infant graves dis* [tiab] OR infant hyperthyroidism [tiab]

2 Supplementary Table S1. Assays Used for Determination of TRAb Levels in Included Studies Study Abeillon-du Payrat (S1) Bjørgaas (S2) Clavel (S3) Dierickx (S4) Duncombe (S5) Elston (S6) Gietka-Czernel (S7) Gietka-Czernel (S8) Kamijo (S9) Laurberg (S10) Matsumoto (S11) Radetti (S12) Rakover (S13) Resch (S14) Rink (S15) Roth (S16) Uenaka (S17) Volumenie (S18) Wit (S19) Zuppa (S20) Assay 2nd generation, htrab, BRAHMS (NV <1.5 IU/L) 2nd generation, ptrab, MEDIPAN (NV <1.0 IU/L) 1st generation, ptrab, BEHRING (NV <10.0 U/L) 2nd generation, htrab, BRAHMS (NV <1.0 U/L) 1st generation, ptrab (NV <10 U/L) 2nd generation, htrab, BRAHMS (NV <1.5 U/L) 3rd generation, ptrab, ROCHE(NV <1.8 IU/mL) 3rd generation, ptrab, ROCHE( NV <1.8 IU/mL) 1st generation, ptrab, BRAHMS, COSMIC (NV <50%/40 U/L); 2nd generation, ptrab (NV <70%) and htrab, BRAHMS (NV <1.5 IU/L); 3rd generation, ptrab (NV <75%) 1st generation, ptrab, BRAHMS (NV <10 U/L); 2nd generation, htrab, BRAHMS (NV <1.0 U/L) 3rd generation, ptrab, ROCHE (NV <2.0 IU/L) 1st generation, ptrab, HENNING (NV <9 U/L) 1st generation, ptrab, CISBIO (NV <10 U/L) 1st generation, htrab, HENNING (NV <15 U/L) 1st generation, ptrab (NV <15 U/L) Immuno-radiometric assay (NV <8 U/L) 2nd generation, htrab, YAMASA Japan (NV <1 IU/L) 1st generation, ptrab, BRAHMS (NV <14 IU/L) 1st generation, ptrab (NV unknown) Generation unknown (NV <12 U/mL) NV, normal value; ptrab, porcine TRAb assay; htrab, human TRAb assay.

3 Supplementary Table S2. Summary of Selected Cohort Studies, Case Series, and Case Reports for Radioimmunoassays TRAb Study Population Thyrotoxicosis (n) Maternal TRAb Diagnosis of fetal/neonatal thyrotoxicosisis Assay Abeillon-du Payrat (S1) 20 mothers; 4 neonates Hamada (S21) 45 mothers; 44 neonates Higuchi (S22) 1 mother; 1 neonate Matsuda (S23) 3 mothers; 3 neonates Matsuura (S24) 56 mothers; 57 neonates Mortimer (S25) 46 mothers; 48 neonates Smith (S26) 5 mothers; 7 neonates Volpé (S27) 2 mothers; 2 neonates Wit (S19) 1 mother; 2 neonates n = 4 TBII 973%; TBII 1584%; TBII 412%; TBII 863% n = 5 TRAb % (delivery) n = 1 TRAb 62% ft4, ftsh, and clinical (tachycardia, goiter) n = 1 TBII 77.2% (T2); TBII 54.8 (T3) n = 14 TBII average % TSH, ft4 TBII radioreceptor assay kit (TRAK; human, Thermo Fisher Scientific, Clinical Diagnostics; BRAHMS GmbH, Hennigsdorf, Germany) Not specified Radioreceptor assay (Cosmic Co., Tokyo, Japan); reference range -10% to +10% Not specified; TRAb (NV <15%) Clinical (hyperactive, diarrhea) TBII NV <10%; assay not specified ft4, TSH, clinical (restlessness, sweating, exophthalmos) n = 4 TBII >70% Clinical (goiter, tachycardia, irritable) n = 3 (1 twin) TBII 83% (T2); TBII 54% (T2) n = 2 TBII 1380% (T3); TBII 1320% (T3) T4, TSH, and clinical (tachycardia, goiter) ft4, ftsh, and clinical (tachycardia, goiter) Radioreceptor assay (normal range +15% to -15%) Radioreceptor assay (normal range +15% to -15%) TBII by TRAK assay (NV <15%) TBII radioligand assay (NV <30%) n = 2 TRAb 84% ft4, clinical (tachycardia, goiter) TRAb assay (Rees-Smith laboratorium), not specified TBII, thyrotropin binding inhibitor immunoglobulins; TSH, thyrotropin; ft4, free thyroxine; ft3, free triiodothyronine; T1, T2, and T3, trimesters 1, 2, and 3; ATD, antithyroid drugs; FH, fetal hyperthyroidism; NH, neonatal hyperthyroidism.

4 Supplementary Table S3. Summary of Selected Cohort Studies, Case Series, and Case Reports for Radioimmunoassay TSI Study Population Thyrotoxicosis (n) Maternal TSI Diagnosis of fetal/neonatal thyrotoxicosis Assay Borrás-Perez (S28) 2 mothers; 3 neonates (1 twin) Clavel (S3) 35 mothers; 35 neonates Kamijo (S9) 47 mothers; 47 neonates Levy-Shraga (S29) 96 mothers; 96 neonates McKenzie and Zakarija (S30) 4 mothers; 4 neonates Mitsuda (S31) 230 mothers; 230 neonates Nachum (S32) 18 mothers; 26 neonates Peleg (S33) 29 mothers; 35 neonates Rakover (S13) 1 mother; 1 neonate Wallace (S34) 1 mother; 1 neonate Zakarija (S35) 17 mothers; 20 neonates n = 3 TSI 87 U/L (only before pregnancy); TSI 55% (T2) TSH, ft4 Commercial radioimmunoassay (NV <10%) n = 7 TSAB >350% ft3 Detection of camp release by radioimmunoassay n = 2 TSAb 433%; TSAb % n = 3 TSI 486%; TSI 212%; TSI 358% n = 2 TSAb 503%; TSAb 1267% n = 13 a TSAb <15% (4); TSAb 15 30% (1); TSAb 30 50% (2); TSAb 50 70% (2); TSAb >70% (4) n = 2 TSAb % (T2); TSAb 259% n = 6 TSI 1500% (T3); TSI 580% (T3); TSI 1300% (T3); TSI 850% (T3); TSI 690% (T3); TSI 990% (T3) n = 1 TSAb % (T2, T3) Clinical, biochemical (not further specified) ft4, ftsh, and clinical (tachycardia, goiter) Detection of camp release by radioimmunoassay Radioimmunoassay (RIA); positive when specimen-to-reference ratio 140% of the reference control Not specified Stimulation of the human thyroid slice Clinical (tachycardia, irritable) and/or chemical (T4, TSH) T4, TSH, and clinical (tachycardia, goiter) ft4, ftsh, and clinical (tachycardia, goiter) Fetal TBII, goiter, tachycardia; neonatal ft4, TSH, goiter and clinical (irritable, tachycarcia) in vitro; measured as an increase in the concentration of cyclic AMP Radioreceptor-assay commercial kit (Baxter Co. Japan; NV <15%) Bioassay >160%, not specified further Radioimmunoassay (NV <130%) n = 1 TSI 1100% (T3) Fetal tachycardia Bioassay (NV 130%) n = 8 TSAb 2576%; TSAb 2536%; TSAb 2429%; TSAb 2011%; TSAb 1267%; TSAb 917%; TSAb 811%; TSAb 503% Not specified Not specified Capacity of serum immunoglobulin preparation to stimulate camp in cultured human thyroid cells (NV <160%) a Numbers in parentheses indicate patients per TSAb range. TSAb, thyroid-stimulating antibody; TSI, thyroid-stimulating immunoglobulin; TSH, thyrotropin; ft4, free thyroxine; ft3, free triiodothyronine; T1, T2, and T3, trimesters 1, 2, and 3; US, ultrasound.

5 Supplementary Table S4. Critical Appraisal of Case Reports and Case Series Using Quality Assessment Tool for Case-Series Studies

6 Supplementary Table S5. Critical Appraisal of Case Reports and Case Series Using Critical Appraisal of a Case Study

7 PF, prognostic factor. Supplementary Table S6. Critical Appraisal of Cohort Studies

8 Supplementary References S1. Abeillon-du Payrat J, Chikh K, Bossard N, Bretones P, Gaucherand P, Claris O, Charrie A, Raverot V, Orgiazzi J, Borson-Chazot F, Bournaud C 2014 Predictive value of maternal second-generation thyroid-binding inhibitory immunoglobulin assay for neonatal autoimmune hyperthyroidism. Eur J Endocrinol 171: S2. Bjorgaas MR, Farstad H, Christiansen SC, Blaas HG 2013 Impact of thyrotropin receptor antibody levels on fetal development in two successive pregnancies in a woman with Graves disease. Horm Res Paediatr 79: S3. Clavel S, Madec AM, Bornet H, Deviller P, Stefanutti A, Orgiazzi J 1990 Anti TSH-receptor antibodies in pregnant patients with autoimmune thyroid disorder. Br J Obstet Gynaecol 97: S4. Dierickx I, Decallonne B, Billen J, Vanhole C, Lewi L, De Catte L, Verhaeghe J 2014 Severe fetal and neonatal hyperthyroidism years after surgical treatment of maternal Graves disease. J Obstet Gynaecol 34: S5. Duncombe GJ, Dickinson JE 2001 Fetal thyrotoxicosis after maternal thyroidectomy. Aust N Z J Obstet Gynaecol 41: S6. Elston MS, Tu akoi K, Meyer-Rochow GY, Tamatea JA, Conaglen JV 2014 Pregnancy after definitive treatment for Graves disease does treatment choice influence outcome? Aust N Z J Obstet Gynaecol 54: S7. Gietka-Czernel M, Debska M, Kretowicz P, Jastrzebska H, Zgliczynski W 2014 Increased size and vascularisation, plus decreased echogenicity, of foetal thyroid in twodimensional ultrasonography caused by maternal Graves disease. Endokrynol Pol 65: S8. Gietka-Czernel M, Debska M, Kretowicz P, Zgliczynski W, Oltarzewski M 2014 Hyperthyroidism during pregnancy the role of measuring maternal TSH receptor antibodies and foetal ultrasound monitoring. Endokrynol Pol 65: S9. Kamijo K 2007 TSH-receptor antibodies determined by the first, second and third generation assays and thyroidstimulating antibody in pregnant patients with Graves disease. Endocr J 54: S10. Laurberg P, Nygaard B, Glinoer D, Grussendorf M, Orgiazzi J 1998 Guidelines for TSH-receptor antibody measurements in pregnancy: results of an evidence-based symposium organized by the European Thyroid Association. Eur J Endocrinol 139: S11. Matsumoto T, Miyakoshi K, Saisho Y, Ishii T, Ikenoue S, Kasuga Y, Kadohira I, Sato S, Momotani N, Minegishi K, Yoshimura Y 2013 Antenatal management of recurrent fetal goitrous hyperthyroidism associated with fetal cardiac failure in a pregnant woman with persistent high levels of thyroid-stimulating hormone receptor antibody after ablative therapy. Endocr J 60: S12. Radetti G, Persani L, Moroder W, Cortelazzi D, Gentili L, Beck-Peccoz P 1999 Transplacental passage of antithyroid auto-antibodies in a pregnant woman with autoimmune thyroid disease. Prenat Diagn 19: S13. Rakover Y, Weiner E, Mosh N, Shalev E 1999 Fetal pituitary negative feedback at early gestational age. Clin Endocrinol (Oxf) 50: S14. Resch B, Mache C, Rosegger H, Hausler M 1995 [Neonatal hyperthyroidism caused by TSH receptor antibodies in maternal autoimmune hyperthyroidism]. Z Geburtshilfe Neonatol 199: S15. Rink T, Wieg C, Schroth HJ, Helisch A, Bertram U 1999 [Hyperthyroidism in a premature infant due to transplacental passage of maternal thyrotropin receptor antibodies]. Nuklearmedizin 38: S16. Roth C, Siggelkow H, Gruters A, Hufner M, Lakomek M 1997 [Neonatal Basedow s disease in twins from a mother with severe T3 hyperthyroidism]. Dtsch Med Wochenschr 122: S17. Uenaka M, Tanimura K, Tairaku S, Morioka I, Ebina Y, Yamada H 2014 Risk factors for neonatal thyroid dysfunction in pregnancies complicated by Graves disease. Eur J Obstet Gynecol Reprod Biol 177: S18. Volumenie JL, Polak M, Guibourdenche J, Oury JF, Vuillard E, Sibony O, Reyal F, Raccah-Tebeka B, Boissinot C, Madec AM, Orgiazzi J, Toubert ME, Leger J, Blot P, Luton D 2000 Management of fetal thyroid goitres: a report of 11 cases in a single perinatal unit. Prenat Diagn 20: S19. Wit JM, Rees-Smith B, Creagh FM, Bruinse HW, van der Heide D, Docter R, Gerards LJ 1986 Thyroid-stimulating immunoglobulins and thyroid function tests in two siblings with neonatal thyrotoxicosis. Eur J Pediatr 145: S20. Zuppa AA, Sindico P, Savarese I, D Andrea V, Fracchiolla A, Cota F, Romagnoli C 2007 Neonatal hyperthyroidism: neonatal clinical course of two brothers born to a mother with Graves Basedow disease, before and after total thyroidectomy. J Pediatr Endocrinol Metab 20: S21. Hamada N, Momotani N, Ishikawa N, Yoshimura Noh J, Okamoto Y, Konishi T, Ito K, Ito K 2011 Persistent high TRAb values during pregnancy predict increased risk of neonatal hyperthyroidism following radioiodine therapy for refractory hyperthyroidism. Endocr J 58: S22. Higuchi R, Kumagai T, Kobayashi M, Minami T, Koyama H, Ishii Y 2001 Short-term hyperthyroidism followed by transient pituitary hypothyroidism in a very low birth weight infant born to a mother with uncontrolled Graves disease. Pediatrics 107:E57. S23. Matsuda T, Momoi T, Akaishi K, Yagura T, Kasagi K, Endo K 1988 Transient neonatal hyperthyroidism and maternal thyroid stimulating immunoglobulins. Arch Dis Child 63: S24. Matsuura N, Konishi J, Fujieda K, Kasagi K, Iida Y, Hagisawa M, Fujimoto S, Fukushi M, Takasugi N 1988 TSH-receptor antibodies in mothers with Graves disease and outcome in their offspring. Lancet 1: S25. Mortimer RH, Tyack SA, Galligan JP, Perry-Keene DA, Tan YM 1990 Graves disease in pregnancy: TSH receptor binding inhibiting immunoglobulins and maternal and neonatal thyroid function. Clin Endocrinol (Oxf) 32: S26. Smith C, Thomsett M, Choong C, Rodda C, McIntyre HD, Cotterill AM 2001 Congenital thyrotoxicosis in premature infants. Clin Endocrinol (Oxf) 54: S27. Volpé R, Ehrlich R, Steiner G, Row VV 1984 Graves disease in pregnancy years after hypothyroidism with recurrent passive-transfer neonatal Graves disease in offspring. Therapeutic considerations. Am J Med 77: S28. Borrás-Pérez MV, Moreno-Pérez D, Zuasnabar-Cotro A, López-Siguero JP 2001 Neonatal hyperthyroidism in infants of mothers previously thyroidectomized due to Graves disease. J Pediatr Endocrinol Metab 14:

9 S29. Levy-Shraga Y, Tamir-Hostovsky L, Boyko V, Lerner- Geva L, Pinhas-Hamiel O 2014 Follow-up of newborns of mothers with Graves disease. Thyroid 24: S30. McKenzie JM, Zakarija M 1992 Fetal and neonatal hyperthyroidism and hypothyroidism due to maternal TSH receptor antibodies. Thyroid 2: S31. Mitsuda N, Tamaki H, Amino N, Hosono T, Miyai K, Tanizawa O 1992 Risk factors for developmental disorders in infants born to women with Graves disease. Obstet Gynecol 80: S32. Nachum Z, Rakover Y, Weiner E, Shalev E 2003 Graves disease in pregnancy: prospective evaluation of a selective invasive treatment protocol. Am J Obstet Gynecol 189: S33. Peleg D, Cada S, Peleg A, Ben-Ami M 2002 The relationship between maternal serum thyroid-stimulating immunoglobulin and fetal and neonatal thyrotoxicosis. Obstet Gynecol 99: S34. Wallace C, Couch R, Ginsberg J 1995 Fetal thyrotoxicosis: a case report and recommendations for prediction, diagnosis, and treatment. Thyroid 5: S35. Zakarija M, McKenzie JM 1983 Pregnancy-associated changes in the thyroid-stimulating antibody of Graves disease and the relationship to neonatal hyperthyroidism. J Clin Endocrinol Metab 57:

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