A Newborn by Normal Vaginal Delivery Is Brought for Routine

A newborn by normal vaginal delivery is brought for routine screening. you found an increase in TSH and low thyroxine T4. Apgar scores were 8 and 9 at 1 and 5 minutes, respectively. Physical examination reveals an enlarged thyroid gland in the normal position. Neck ultrasound confirms thyroid enlargement. Which of the following is the most likely cause of this patient's findings?

A) Maternal intake of levothyroxine
B) Maternal intake of propranolol
C) Maternal intake of propylthiouracil
D) Transplacental passage of thyroglobulin
E) Transplacental passage of TSH receptor-stimulating antibodies
The transplacental passage of maternal antithyroid medications (eg, propylthiouracil) , which inhibit thyroid peroxidase and cause congenital goiter with hypofunctional of thyroid.