Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Department of Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, ON, Canada.
BMC Pediatr. 2024 Aug 1;24(1):490. doi: 10.1186/s12887-024-04963-0.
As the fetus relies on maternal thyroid hormones in early pregnancy, maternal hypothyroidism plays an important role in fetal development. However, the association between maternal hypothyroidism and metabolic disease in offspring is unclear.
To examine the association between maternal hypothyroidism in pregnancy and metabolic outcomes (obesity, hypertension, type 2 diabetes mellitus, and dyslipidemia) in children < 18 years.
We systematically searched 5 databases from inception to May 2023. Eligible studies included cohort, case-control, and randomized controlled trials involving children born to mothers with or without hypothyroidism in pregnancy. Data were pooled across studies using random-effects models for outcomes reported in at least three studies. Quality assessment was performed using the ROBINS-E tool for observational studies and the Cochrane Risk of Bias tool for trials.
The search identified 3221 articles, of which 7 studies were included (1 trial, 6 observational). All studies were conducted outside of North America and ranged in size from 250 to > 1 million children. The follow-up time ranged from 6 to 20 years. Included studies support an increased risk of hypertension and glucose dysregulation in offspring exposed to maternal hypothyroidism (hypertension: OR 1.08, 95% CI 0.75, 1.57 and HR 1.81, 95% CI 1.21, 2.69; diabetes: RR 2.7, 95% CI 0.7, 10). In the pooled analysis, maternal hypothyroidism was not associated with obesity in offspring (OR 1.04, 95% CI 0.64, 1.70).
This study found inconsistent evidence on the association between maternal hypothyroidism in pregnancy and metabolic outcomes in offspring, though associations with hypertension and glucose dysregulation are possible.
由于胎儿在妊娠早期依赖于母体甲状腺激素，因此母体甲状腺功能减退症在胎儿发育中起着重要作用。然而，母体甲状腺功能减退症与后代代谢疾病之间的关联尚不清楚。
检查妊娠期间母体甲状腺功能减退症与<18 岁儿童代谢结局（肥胖、高血压、2 型糖尿病和血脂异常）之间的关系。
我们从建立到 2023 年 5 月系统地搜索了 5 个数据库。符合条件的研究包括队列研究、病例对照研究和随机对照试验，涉及妊娠期间患有或未患有甲状腺功能减退症的母亲所生的儿童。对于至少有 3 项研究报告的结局，使用随机效应模型对来自不同研究的数据进行汇总。使用 ROBINS-E 工具对观察性研究进行质量评估，使用 Cochrane 偏倚风险工具对试验进行质量评估。
搜索共确定了 3221 篇文章，其中 7 项研究入选（1 项试验，6 项观察性研究）。所有研究均在北美以外进行，规模从 250 到超过 100 万儿童不等。随访时间从 6 年到 20 年不等。纳入的研究支持暴露于母体甲状腺功能减退症的后代患高血压和葡萄糖调节障碍的风险增加（高血压：OR 1.08，95%CI 0.75，1.57 和 HR 1.81，95%CI 1.21，2.69；糖尿病：RR 2.7，95%CI 0.7，10）。在汇总分析中，母体甲状腺功能减退症与后代肥胖无关（OR 1.04，95%CI 0.64，1.70）。
本研究发现妊娠期间母体甲状腺功能减退症与后代代谢结局之间的关联证据不一致，但与高血压和葡萄糖调节障碍的关联是可能的。
