Obstetrical complications of thyroid peroxidase antibody positive during pregnancy and effects of intervention:a meta-analysis / 中华妇产科杂志

ABSTRACT

Objective To explore the correlation between thyroid peroxidase antibody (TPOAb) and outcomes during pregnancy and the effects of treatment on outcomes. Methods PubMed, Cochrane Library, Science Direct, Embase, Chinese Biomedicine, and Wanfangdata had been searched. Case-control and cohort studies about TPOAb and pregnancy outcomes were searched according to the inclusion and exclusion criteria. Fifty studies were finally recruited (all of cohort-studies, 10 for English and 5 for Chinese). Review Manager 5.3 were used to test the heterogeneity of the results among the different studies and amalgamate the effect size using fixed or random effect models. Results Meta-analysis showed TPOAb (+)with normal thyroid function increase the risks of miscarriage,and premature delivery, OR calculated were 2.02(95%CI1.13-3.62, P=0.001)and 1.39(95%CI1.11-1.76, P=0.005), while showed no relative risk to hypertensive disease,placental abruption in pregnancy and fetal growth restriction, OR calculated were 1.29(95%CI1.00-1.67, P=0.080),0.42(95%CI0.12-1.43, P=0.210)and 1.61(95%CI0.23-11.12, P=0.100). TPOAb(+)with normal thyroid function increase miscarriage in in vitro fertilization and embryo transfer (IVF-ET), OR calculated were 2.14(95%CI1.43-3.21, P=0.000). Levothyroxine (LT4) for patients of TPOAb(+)with normal thyroid dysfunction decrease adverse obstetric outcomes, OR calculated were 0.43(95%CI0.22-0.85, P=0.020). Conclusions TPOAb(+)with normal thyroid function increase the risks of miscarriage,and premature delivery. TPOAb(+) with normal thyroid function increase miscarriage in IVF-ET. LT4 for patients of TPOAb(+)with normal thyroid dysfunction decrease adverse obstetric outcomes.