Significance of (sub)clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy: a systematic review Full Text
Human Reproduction Update, 06/08/2011
Evidence Based Medicine
Van den Boogaard E et al. – Pregnant women with subclinical hypothyroidism or thyroid antibodies have an increased risk of complications, especially pre–eclampsia, perinatal mortality and (recurrent) miscarriage.Methods
- Relevant studies were identified by searching Medline, EMBASE and the Cochrane Controlled Trials Register.
- From a total of 14,208 primary selected titles, 43 articles were included for the systematic review and 38 were appropriate for meta-analyses.
- No articles about hyperthyroidism were selected.
- Subclinical hypothyroidism in early pregnancy, compared with normal thyroid function, was associated with the occurrence of pre-eclampsia [odds ratio (OR) 1.7, 95% confidence interval (CI) 1.1–2.6] and an increased risk of perinatal mortality (OR 2.7, 95% CI 1.6–4.7).
- In the meta-analyses, the presence of thyroid antibodies was associated with an increased risk of unexplained subfertility (OR 1.5, 95% CI 1.1–2.0), miscarriage (OR 3.73, 95% CI 1.8–7.6), recurrent miscarriage (OR 2.3, 95% CI 1.5–3.5), preterm birth (OR 1.9, 95% CI 1.1–3.5) and maternal post-partum thyroiditis (OR 11.5, 95% CI 5.6–24) when compared with the absence of thyroid antibodies.