Thyroid autoimmunity and miscarriage: a meta-analysis
10.3760/cma.j.issn.1000-6699.2010.03.008
- VernacularTitle:甲状腺自身免疫与流产关联性的meta分析
- Author:
Lili CHEN
;
Chao LIU
- Publication Type:Journal Article
- Keywords:
Thyroid;
Thyroid autoimmune;
Miscarriage;
Meta-analysis
- From:
Chinese Journal of Endocrinology and Metabolism
2010;26(3):203-208
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the association between thyroid autoimmunity (TAI) and miscarriage.Methods A systematic review of both case-control and cohort studies on the association between TAI and miscarriage published before March 2009 was performed.All the literatures were abstracted based on the defined selection criteria by two independent investigators.Publication bias was tested by funnel plot.The odd ratios of case-control studies and relative risks of cohort studies were pooled respectively,depending on the result of heterogeneity test among the individual studies.The software Review Manager (version 4.3.1) was used for meta analysis.Results Electronic search yielded 23 articles,4 of which were reviews and were excluded.The remaining 19 clinical studies met the selection criteria,of which 7 were case-control studies and 12 cohort studies.A clear association between the presence of thyroid autoantibodies (TA) and miscarriage was found with a pooled odds ratio of 2.72 (95% CI 1.27-5.80,P = 0.01) in 7 case-control studies,and a pooled relative risk of 2.41 (95% CI 1.96-2.96,P＜0.01) in 12 cohort studies.Women with TA were found to have slightly older age (age difference,1.29 years,95% CI 0.43-2.16,P = 0.003) and raised TSH levels (TSH difference,0.61 mIU/L,95% CI 0.51-0.71,P＜0.01) compared with those without TA.Conclusion TAI is significantly associated with miscarriage,which can be interpreted as the direct involvement of TA.Alternatively,the association can be partially explained by the slightly older age in women with TA compared with those without.A third possibility is mild thyroid failure,as TSH levels in TA-positive but euthyroid women are higher than in TA-negative women.
