Li M, Wang S W, Huang S, Mao Y
Department of Obstetrics and Gynecology, Beijing Hospital, Beijing 100730, China.
Zhonghua Fu Chan Ke Za Zhi. 2016 May 25;51(5):339-44. doi: 10.3760/cma.j.issn.0529-567X.2016.05.004.
To evaluate the relationship between thyroid autoimmunity and the risk of preterm birth.
Literature search was done among PubMed, Embase, Wanfang Medical Database, China Academic Journal Network Publishing Database and China Biology Medicine disc from Jan. 1(st) 1980 to July 31(st), 2015. (1) Literature were extracted according to inclusion and exclusion standards, and the quality of the extracted literature were evaluated by Newcastle-Ottawa Scale (NOS). (2) Meta-analysis was performed by RevMan 5 software formulated by using the Cochrane library databases. Various heterogeneity of the research was inspected firstly. According to the results of the inspection a certain effect model was selected (including fixed effects model, the random effects model) to be utilized in merger analysis. In this study pregnant women with both thyroid peroxidase antibodies (TPO-Ab) and thyroglobulin (TG-Ab) positive were defined as thyroid antibody positive pregnant women. Pregnant women with only TPO-Ab positive were defined as TPO-Ab positive pregnant women. Then the relationship of antibody positive and the risk of a preterm birth was analyzed respectively.
(1) Ten cohort studies were enrolled, of which NOS scale score were 7 or higher. All the studies are of medium quality and above. A total of 1 322 cases of preterm birth occurred among 19 910 pregnant women. (2) Positive thyroid autoantibodies did not increase the risk of preterm birth in euthyroid pregnant women (OR=1.41, 95%CI: 0.83-2.40, P=0.200) or in pregnant women with hypothyroidism (OR=0.68, 95% CI: 0.32-1.44, P=0.310) . Positive TPO-Ab in euthyroid pregnant women increase the risk of preterm birth significantly (OR=2.08, 95%CI: 1.09-3.97, P=0.030), but positive TPO-Ab in pregnant women with hypothyroidism did not increase the risk of preterm birth significantly (OR=1.21, 95%CI: 0.65-2.24, P=0.550).
Positive TPO-Ab is an independent risk factor of preterm birth in euthyroid pregnant women.
评估甲状腺自身免疫与早产风险之间的关系。
检索1980年1月1日至2015年7月31日期间的PubMed、Embase、万方医学数据库、中国学术期刊网络出版总库和中国生物医学文献数据库。（1）根据纳入和排除标准提取文献，并采用纽卡斯尔-渥太华量表（NOS）对提取文献的质量进行评估。（2）使用Cochrane图书馆数据库制定的RevMan 5软件进行荟萃分析。首先检查研究的各种异质性。根据检查结果选择某种效应模型（包括固定效应模型、随机效应模型）用于合并分析。在本研究中，甲状腺过氧化物酶抗体（TPO-Ab）和甲状腺球蛋白（TG-Ab）均阳性的孕妇被定义为甲状腺抗体阳性孕妇。仅TPO-Ab阳性的孕妇被定义为TPO-Ab阳性孕妇。然后分别分析抗体阳性与早产风险之间的关系。
（1）纳入10项队列研究，其中NOS量表评分均为7分及以上。所有研究质量均为中等及以上。19910名孕妇中共有1322例早产。（2）甲状腺自身抗体阳性在甲状腺功能正常的孕妇中未增加早产风险（OR = 1.41，95%CI：0.83 - 2.40，P = 0.200），在甲状腺功能减退的孕妇中也未增加早产风险（OR = 0.68，95%CI：0.32 - 1.44，P = 0.310）。甲状腺功能正常的孕妇中TPO-Ab阳性显著增加早产风险（OR = 2.08，95%CI：1.09 - 3.97，P = 0.030），但甲状腺功能减退的孕妇中TPO-Ab阳性未显著增加早产风险（OR = 1.21，95%CI：0.65 - 2.24，P = 0.550）。
TPO-Ab阳性是甲状腺功能正常孕妇早产的独立危险因素。
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