Parizad Nasirkandy Marzieh, Badfar Gholamreza, Shohani Masoumeh, Rahmati Shoboo, YektaKooshali Mohammad Hossein, Abbasalizadeh Shamsi, Soleymani Ali, Azami Milad
Department of Obstetrics and Gynecology, Women's Reproductive Health Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Pediatrics, Behbahan Faculty of Medical Sciences, Ahvaz Jundishapour University of Medical science, Behbahan, Iran.
Int J Reprod Biomed. 2017 Sep;15(9):543-552.
The clinical consequences of hypothyroidism and hypothyroxinemia during pregnancy such as preterm birth are not still clear.
The aim of this meta-analysis was to estimate the relation of clinical and subclinical hypothyroidism and hypothyroxinemia during pregnancy and preterm birth.
In this meta-analysis, Preferred Reporting Items for Systematic review and Meta-Analysis were utilized. Searching the cohort studies were done by two researchers independently without any restrictions on Scopus, PubMed, Science Direct, Embase, Web of Science, CINAHL, Cochrane, EBSCO and Google Scholar databases up to 2017. The heterogeneity of the studies was checked by the Cochran's Q test and I index. Both random and fixed-effects models were used for combining the relative risk and 95% confidence intervals. Data were analyzed using Comprehensive Meta-Analysis software version 2.
Twenty-three studies were included in the meta-analysis. The relative risks of the clinical hypothyroidism, subclinical hypothyroidism and hypothyroxinemia during pregnancy on preterm birth was estimated 1.30 (95% CI: 1.05-1.61, p=0.013, involving 20079 cases and 2452817 controls), 1.36 (95% CI: 1.09-1.68, p=0.005, involving 3580 cases and 64885 controls) and 1.31 (95% CI: 1.04-1.66, p=0.020, involving 1078 cases and 44377 controls), respectively.
The incidence of preterm birth was higher among mothers with clinical and subclinical hypothyroidism or hypothyroxinemia during pregnancy compared to euthyroid mothers, and these relations were significant. Therefore, gynecologists and endocrinologists should manage these patients to control the incidence of adverse pregnancy outcomes such as preterm birth.
孕期甲状腺功能减退和低甲状腺素血症的临床后果，如早产，目前仍不明确。
本荟萃分析的目的是评估孕期临床和亚临床甲状腺功能减退及低甲状腺素血症与早产之间的关系。
在本荟萃分析中，采用了系统评价和荟萃分析的首选报告项目。由两名研究人员独立检索队列研究，截至2017年，对Scopus、PubMed、Science Direct、Embase、Web of Science、CINAHL、Cochrane、EBSCO和谷歌学术数据库无任何限制。通过 Cochr an's Q检验和I指数检查研究的异质性。随机效应模型和固定效应模型均用于合并相对风险和95%置信区间。使用综合荟萃分析软件版本2进行数据分析。
23项研究纳入荟萃分析。孕期临床甲状腺功能减退、亚临床甲状腺功能减退和低甲状腺素血症导致早产的相对风险分别估计为1.30（95%CI：1.05 - 1.61，p = 0.013，涉及20079例病例和2452817例对照）、1.36（95%CI：1.09 - 1.68，p = 0.005，涉及3580例病例和64885例对照）和1.31（95%CI：1.04 - 1.66，p = 0.020，涉及1078例病例和44377例对照）。
与甲状腺功能正常的母亲相比，孕期患有临床和亚临床甲状腺功能减退或低甲状腺素血症的母亲早产发生率更高，且这些关系具有显著性。因此，妇科医生和内分泌科医生应管理这些患者，以控制早产等不良妊娠结局的发生率。
