Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Community Medicine, School of Medicine, Hormozgan University of Medical Sciences, Bandar-Abbas, Iran.
BMC Endocr Disord. 2022 Sep 26;22(1):240. doi: 10.1186/s12902-022-01154-9.
Preeclampsia is a life-threatening disorder during pregnancy and postpartum periods. Preeclampsia can affect the activity of many organs. It is very important because if this disorder is associated with changes in thyroid function, it can affect the results of maternal and fetal tests. Accordingly, the aim of this meta-analysis study was to assess the abnormalities in thyroid function tests in preeclampsia.
Studies were selected through a systematic search of the MEDLINE/PubMed, Scopus, Web of Science Core Collection, and Google Scholar databases in 31st August 2021. Also, reference lists of review articles and relevant studies were manual-searched to identify other potentially eligible studies. English studies that compared TSH, T4 and T3 of normal pregnant with preeclamptic women (Known to be normotensive before pregnancy; gestational age 20 week or more; singleton pregnancy; no previous history of thyroid dysfunction) were screened. Data sets were screened for eligibility by two independent reviewers. Articles were assessed by the Newcastle-Ottawa Scale. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used for quality assessment of evidence on outcome levels.
After reviewing 886 published studies, 63 observational studies were selected and used for this meta-analysis. The study population included 21,528 pregnant women. The findings revealed that TSH (SMD = 1.70, 95%CI: 1.39 to 2.02; p < 0.001) was significantly higher in preeclamptic women. TT4 (SMD = -0.82, 95%CI: -1.16, -0.49; p < 0.001), TT3 (SMD = -0.88, 95%CI: -1.36 to -0.41; p < 0.001) and FT3 (SMD = -0.59, 95%CI: -0.91 to -0.27; p < 0.001) were less in preeclamptic women. There was no statistically significant difference in FT4 between two groups (SMD = 0.002, 95%CI: -0.27 to 0.27; p = .990). The results of publication bias and sensitivity analysis confirmed the reliability and stability of this meta-analysis. The quality of evidence was regarded as moderate, low, and very low for these risk factors according to the GRADE approach.
Findings of this meta-analysis indicated preeclamptic women were more at risk of changes in thyroid function tests. In order to prevent thyroid disorders, it is recommended that thyroid function tests be performed in women with pre-eclampsia.
子痫前期是妊娠和产后期间危及生命的疾病。子痫前期会影响许多器官的功能。这非常重要，因为如果这种疾病与甲状腺功能变化有关，它可能会影响母婴检测的结果。因此，本荟萃分析研究的目的是评估子痫前期甲状腺功能检测的异常。
我们通过系统检索 2021 年 8 月 31 日的 MEDLINE/PubMed、Scopus、Web of Science 核心合集和 Google Scholar 数据库，选择研究。此外，还通过手动检索综述文章和相关研究的参考文献列表来确定其他可能符合条件的研究。筛选了比较正常孕妇（已知妊娠前血压正常；妊娠 20 周或以上；单胎妊娠；无甲状腺功能障碍史）和子痫前期妇女的 TSH、T4 和 T3 的英文研究。两名独立评审员筛选数据集以确定其合格性。使用纽卡斯尔-渥太华量表评估文章。使用推荐评估、制定和评估（GRADE）方法对结局水平的证据质量进行评估。
在审查了 886 篇已发表的研究后，选择了 63 项观察性研究用于本荟萃分析。研究人群包括 21528 名孕妇。研究结果显示，子痫前期妇女的 TSH（SMD=1.70，95%CI：1.39 至 2.02；p<0.001）明显升高。TT4（SMD=-0.82，95%CI：-1.16，-0.49；p<0.001）、TT3（SMD=-0.88，95%CI：-1.36 至-0.41；p<0.001）和 FT3（SMD=-0.59，95%CI：-0.91 至-0.27；p<0.001）均降低。两组间 FT4 无统计学显著差异（SMD=0.002，95%CI：-0.27 至 0.27；p=0.990）。发表偏倚和敏感性分析的结果证实了本荟萃分析的可靠性和稳定性。根据 GRADE 方法，这些危险因素的证据质量被认为是中度、低和极低。
本荟萃分析的结果表明，子痫前期妇女更有可能发生甲状腺功能检测异常。为了预防甲状腺疾病，建议对子痫前期妇女进行甲状腺功能检测。
