{"title":"母亲亚临床甲状腺功能亢进和不良妊娠结局:观察性研究的系统回顾和荟萃分析。","authors":"Sima Nazarpour, Mina Amiri, Razieh Bidhendi Yarandi, Fereidoun Azizi, Fahimeh Ramezani Tehrani","doi":"10.5812/ijem-120949","DOIUrl":null,"url":null,"abstract":"<p><strong>Context: </strong>Findings from studies evaluating adverse pregnancy outcomes in pregnant women with subclinical hyperthyroidism are conflicting and inconclusive.</p><p><strong>Objectives: </strong>In this systematic review and meta-analysis, our aim was to evaluate the pooled odds ratio (OR) of adverse pregnancy outcomes in women with subclinical hyperthyroidism, compared to euthyroid women.</p><p><strong>Data sources: </strong>Scopus, PubMed (including Medline), and Web of Science databases were systemically searched for regaining published studies to January 2022 examining adverse pregnancy outcomes in women with subclinical hyperthyroidism.</p><p><strong>Study selection: </strong>Outcomes of interest were classified into seven composite outcomes, including hypertensive disorders, preterm delivery, macrosomia/large for gestational age (LGA), pregnancy loss, adverse maternal outcomes, adverse neonatal outcomes, and adverse fetal outcomes.</p><p><strong>Data extraction: </strong>In this meta-analysis, both fixed and random effect models were used. Publication bias was also evaluated by Egger test and the funnel plot, and the trim and fill method was conducted in case of a significant result, to adjust the bias.</p><p><strong>Results: </strong>Of 202 records retrieved through searching databases, 11 studies were selected for the final analyses. There were no significant differences in pooled ORs of hypertensive disorders, preterm delivery, macrosomia/LGA, and pregnancy loss in pregnant women with subclinical hyperthyroidism, compared to the euthyroid controls. The pooled OR of adverse maternal, neonatal, and fetal outcomes in pregnant women with subclinical hyperthyroidism was not statistically significantly different from that of the euthyroid control group.</p><p><strong>Conclusions: </strong>The current meta-analysis demonstrated that subclinical hyperthyroidism in pregnancy is not related with adverse maternal and fetal outcomes. Therefore, clinicians should be avoided unnecessary treatments for pregnant women with subclinical hyperthyroidism.</p>","PeriodicalId":13969,"journal":{"name":"International Journal of Endocrinology and Metabolism","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d5/aa/ijem-20-3-120949.PMC9675093.pdf","citationCount":"1","resultStr":"{\"title\":\"Maternal Subclinical Hyperthyroidism and Adverse Pregnancy Outcomes: A Systematic Review and Meta-analysis of Observational Studies.\",\"authors\":\"Sima Nazarpour, Mina Amiri, Razieh Bidhendi Yarandi, Fereidoun Azizi, Fahimeh Ramezani Tehrani\",\"doi\":\"10.5812/ijem-120949\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Context: </strong>Findings from studies evaluating adverse pregnancy outcomes in pregnant women with subclinical hyperthyroidism are conflicting and inconclusive.</p><p><strong>Objectives: </strong>In this systematic review and meta-analysis, our aim was to evaluate the pooled odds ratio (OR) of adverse pregnancy outcomes in women with subclinical hyperthyroidism, compared to euthyroid women.</p><p><strong>Data sources: </strong>Scopus, PubMed (including Medline), and Web of Science databases were systemically searched for regaining published studies to January 2022 examining adverse pregnancy outcomes in women with subclinical hyperthyroidism.</p><p><strong>Study selection: </strong>Outcomes of interest were classified into seven composite outcomes, including hypertensive disorders, preterm delivery, macrosomia/large for gestational age (LGA), pregnancy loss, adverse maternal outcomes, adverse neonatal outcomes, and adverse fetal outcomes.</p><p><strong>Data extraction: </strong>In this meta-analysis, both fixed and random effect models were used. Publication bias was also evaluated by Egger test and the funnel plot, and the trim and fill method was conducted in case of a significant result, to adjust the bias.</p><p><strong>Results: </strong>Of 202 records retrieved through searching databases, 11 studies were selected for the final analyses. There were no significant differences in pooled ORs of hypertensive disorders, preterm delivery, macrosomia/LGA, and pregnancy loss in pregnant women with subclinical hyperthyroidism, compared to the euthyroid controls. The pooled OR of adverse maternal, neonatal, and fetal outcomes in pregnant women with subclinical hyperthyroidism was not statistically significantly different from that of the euthyroid control group.</p><p><strong>Conclusions: </strong>The current meta-analysis demonstrated that subclinical hyperthyroidism in pregnancy is not related with adverse maternal and fetal outcomes. 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引用次数: 1
摘要
背景:评估亚临床甲状腺功能亢进孕妇不良妊娠结局的研究结果是相互矛盾和不确定的。目的:在这项系统回顾和荟萃分析中，我们的目的是评估亚临床甲状腺功能亢进妇女与甲状腺功能正常妇女的不良妊娠结局的合并优势比(OR)。数据来源:系统检索Scopus、PubMed(包括Medline)和Web of Science数据库，检索截至2022年1月已发表的研究，研究亚临床甲状腺功能亢进妇女的不良妊娠结局。研究选择:关注的结局被分为7个复合结局，包括高血压疾病、早产、巨大儿/大胎龄儿(LGA)、妊娠丢失、孕产妇不良结局、新生儿不良结局和胎儿不良结局。数据提取:本meta分析采用固定效应模型和随机效应模型。采用Egger检验和漏斗图评价发表偏倚，结果显著时采用修剪填充法调整偏倚。结果:从检索数据库检索到的202份文献中，筛选出11份文献进行最终分析。与甲状腺功能正常的对照组相比，亚临床甲状腺功能亢进孕妇高血压疾病、早产、巨大儿/LGA和妊娠丢失的总or值无显著差异。亚临床甲状腺功能亢进孕妇的不良产妇、新生儿和胎儿结局的总OR与甲状腺功能正常对照组相比无统计学差异。结论:目前的荟萃分析表明，妊娠亚临床甲状腺功能亢进与母体和胎儿的不良结局无关。因此，临床医生应避免对亚临床甲亢孕妇进行不必要的治疗。
Maternal Subclinical Hyperthyroidism and Adverse Pregnancy Outcomes: A Systematic Review and Meta-analysis of Observational Studies.
Context: Findings from studies evaluating adverse pregnancy outcomes in pregnant women with subclinical hyperthyroidism are conflicting and inconclusive.
Objectives: In this systematic review and meta-analysis, our aim was to evaluate the pooled odds ratio (OR) of adverse pregnancy outcomes in women with subclinical hyperthyroidism, compared to euthyroid women.
Data sources: Scopus, PubMed (including Medline), and Web of Science databases were systemically searched for regaining published studies to January 2022 examining adverse pregnancy outcomes in women with subclinical hyperthyroidism.
Study selection: Outcomes of interest were classified into seven composite outcomes, including hypertensive disorders, preterm delivery, macrosomia/large for gestational age (LGA), pregnancy loss, adverse maternal outcomes, adverse neonatal outcomes, and adverse fetal outcomes.
Data extraction: In this meta-analysis, both fixed and random effect models were used. Publication bias was also evaluated by Egger test and the funnel plot, and the trim and fill method was conducted in case of a significant result, to adjust the bias.
Results: Of 202 records retrieved through searching databases, 11 studies were selected for the final analyses. There were no significant differences in pooled ORs of hypertensive disorders, preterm delivery, macrosomia/LGA, and pregnancy loss in pregnant women with subclinical hyperthyroidism, compared to the euthyroid controls. The pooled OR of adverse maternal, neonatal, and fetal outcomes in pregnant women with subclinical hyperthyroidism was not statistically significantly different from that of the euthyroid control group.
Conclusions: The current meta-analysis demonstrated that subclinical hyperthyroidism in pregnancy is not related with adverse maternal and fetal outcomes. Therefore, clinicians should be avoided unnecessary treatments for pregnant women with subclinical hyperthyroidism.
期刊介绍：
The aim of the International Journal of Endocrinology and Metabolism (IJEM) is to increase knowledge, stimulate research in the field of endocrinology, and promote better management of patients with endocrinological disorders. To achieve this goal, the journal publishes original research papers on human, animal and cell culture studies relevant to endocrinology.
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