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Levothyroxine treatment and pregnancy outcomes in women with subclinical hypothyroidism: a systematic review and meta-analysis.

Abstract：

PURPOSE:To evaluate the benefits of LT4 treatment on pregnancy outcomes in SCH women. STUDY DESIGN:PubMed [including Medline], Web of Science, Wiley, Google Scholar, Science direct and Scopus were searched for identifying and retrieving all English articles published up to May 2018 on the effects of levothyroxine treatment on pregnancy outcomes in pregnant women with SCH compared to untreated or healthy controls. In this systematic review and meta-analysis, both fixed and random effect models were applied to estimate the pooled effect size. Heterogeneity and publication bias were evaluated using the I-squared (I2) and Begg's statistics, respectively. We also explored heterogeneity sources using meta-regression models and sensitivity analysis. RESULTS:Data of 13 cohort studies and randomized controlled trials with a total of 11,503 participants were analyzed. This meta-analysis showed that pregnant women with SCH treated with levothyroxine had lower chances of pregnancy loss (OR 0.78, 95% CI 0.66-0.94; I2 = 0%) and higher chances for live birth rates (OR 2.72, 95% CI 1.44-5.11; I2 = 25%) than the placebo group. Compared to euthyroid women, SCH patients treated with levothyroxine had higher odds ratio for preterm labor (OR 1.82, 95% CI 1.14-2.91; I2 = 0%). CONCLUSIONS:Results of this study showed that the effects of treatment with levothyroxine in SCH pregnant women are not the same for all pregnancy outcomes. Levothyroxine treatment in these patients can reduce pregnancy loss. Considering the limited number of studies available, further studies are warranted to document more precise data on other consequences.

journal_name

Arch Gynecol Obstet

journal_title

Archives of gynecology and obstetrics

authors

Nazarpour S,Ramezani Tehrani F,Amiri M,Bidhendi Yarandi R,Azizi F

doi

10.1007/s00404-019-05245-2

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

805-819

issue

4

eissn

0932-0067

issn

1432-0711

pii

10.1007/s00404-019-05245-2

journal_volume

300

pub_type

杂志文章,meta分析

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