Obstetric and offspring outcomes in isolated maternal hypothyroxinaemia: a systematic review and meta-analysis.
Obstetric and offspring outcomes in isolated maternal hypothyroxinaemia: a systematic review and meta-analysis.
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孤立性母亲低甲状腺素血症的产科和后代结局：系统评价和荟萃分析
DOI：
10.1007/s40618-022-01967-4
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发表时间：
2023-06
影响因子：
5.4
通讯作者：
Song, Y.
中科院分区：
文献类型：
--
作者：
Zhuo, L.;Wang, Z.;Yang, Y.;Liu, Z.;Wang, S.;Song, Y.
关键词：
研究孤立性母体低甲状腺素血症（IMH）与不良产科结局和后代结局之间的关系，并研究左旋甲状腺素治疗对IMH上述结局的影响。系统检索PubMed、EMBASE、科克伦图书馆，手工检索关键评论的参考文献列表，检索日期为2021年6月9日。两位作者独立筛选标题/摘要。如果信息表明研究符合纳入/排除标准，则对全文进行进一步评估，两名研究人员使用标准化表格进行数据提取和偏倚风险评估。通过随机效应模型计算母体效应和后代结局之间的总体相对风险或平均差异。我们确定了38篇符合条件的文章（35项队列研究和2项随机对照试验[RCT]）。荟萃分析显示，与甲状腺功能正常的妇女相比，母亲IMH与妊娠期糖尿病、早产胎膜早破、早产、胎儿窘迫和巨大儿结局增加相关，相对危险度为1.42（1.03-1.96）、1.50（1.05-2.14）、1.33（1.15-1.55）、1.75（1.16-2.65）和1.62（1.35-1.94）。IMH与前置胎盘、妊娠期高血压、先兆子痫、宫内生长受限和后代结局（如出生体重、低出生体重儿、巨大儿、新生儿重症监护、新生儿死亡或胎儿头围）无关。此外，我们没有发现IMH和不良后代认知缺陷之间的关联。由于Meta分析的数据不足，未能汇集左旋甲状腺素对IMH及其后代的治疗作用的证据。妊娠期IMH可能与一些母儿结局有关。此外，目前还没有足够的证据表明妊娠期左旋甲状腺素治疗可减少不良母体结局和后代残疾。进一步的调查，以探索有益的影响，左旋甲状腺素治疗是必要的。在线版本包含补充材料，可通过10.1007/s40618-022-01967-4获得。
To examine the association between isolated maternal hypothyroxinaemia (IMH) and adverse obstetric outcomes and offspring outcomes and also investigate the effects of levothyroxine therapy on IMH for the above outcomes. We systematically searched PubMed, EMBASE, and Cochrane Library, and the reference lists of key reviews were hand searched on June 9, 2021. Two authors independently screened titles/abstracts. Full articles were further assessed if the information suggested that the study met the inclusion/exclusion criteria, and two researchers performed data extraction and risk-of-bias assessment using standardized tables. Summary relative risks or the mean difference between maternal effects and offspring outcomes were calculated by a random-effects model. We identified 38 eligible articles (35 cohort studies and two randomized controlled trials [RCT]). Meta-analysis showed that maternal IMH was associated with increased gestational diabetes mellitus, preterm premature rupture of membranes, preterm birth, fetal distress, and macrosomia outcomes in IMH compared to euthyroid women, and the relative risks were 1.42 (1.03–1.96), 1.50 (1.05–2.14), 1.33 (1.15–1.55), 1.75 (1.16–2.65) and 1.62 (1.35–1.94), respectively. IMH was not associated with placenta previa, gestational hypertension, pre-eclampsia, intrauterine growth restriction, and offspring outcomes like birth weight, low birth weight infants, fetal macrosomia, neonatal intensive care, neonatal death, or fetal head circumference. In addition, we did not find an association between IMH and adverse offspring cognitive defects. Due to insufficient data for meta-analysis, it failed to pool the evidence of levothyroxine’s therapeutic effect on IMH and their offspring. IMH in pregnancy may relate to a few maternal and offspring outcomes. Moreover, there is currently no sufficient evidence that levothyroxine treatment during pregnancy reduces adverse maternal outcomes and disability in offspring. Further investigation to explore the beneficial effects of levothyroxine therapy is warranted. The online version contains supplementary material available at 10.1007/s40618-022-01967-4.
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影响因子：
5.2
作者：
Chen L;Yang H;Ye E;Lin Z;Peng M;Lin H;Yu L;Cai Z;Lu X
通讯作者：
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影响因子：
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作者：
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影响因子：
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作者：
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DOI：
10.1016/j.beem.2004.03.012
发表时间：
2004-06-01
影响因子：
7.4
作者：
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通讯作者：
del Rey, FE
影响因子：
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作者：
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通讯作者：
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