Effect of levothyroxine on abortion rate and preterm birth rate in pregnant women with thyroid autoimmunity and normal thyroid function: a systematic review and meta-analysis
10.3760/cma.j.cn101441-20210101-00002
- VernacularTitle:左旋甲状腺素片对甲状腺功能正常伴TPO-Ab阳性孕妇的流产率及早产率影响的meta分析
- Author:
Keng FENG
1
;
Yihua YANG
;
Yudi LUO
;
Lingling ZHU
;
Bo LIU
;
Zhiyao WEI
;
Rong DENG
;
Qiuyue WEN
;
Yin BEN
;
Aiping QIN
Author Information
1. 玉林市妇幼保健院生殖中心，玉林537000
- Publication Type:Journal Article
- Keywords:
Thyroid peroxidase;
Autoantibody;
Miscarriage;
Premature delivery
- From:
Chinese Journal of Reproduction and Contraception
2022;42(7):717-723
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of oral levothyroxine on abortion rate and preterm birth rate in pregnant women with thyroid autoimmunity (TAI) and normal thyroid function.Methods:The relevant studies of oral levothyroxine tablets in the treatment of TAI pregnant women were systematically searched in Pubmed, Cochrane, CBM, CNKI, VIP and Wanfang databases. The retrieval period was established until August 2020. Two researchers independently screened the literatures, extracted the data and evaluated the risk of bias in the included study. Meta-analysis was performed using Revman5.3 software.Results:1) Totally six eligible studies were all randomized controlled studies, involving 1427 patients. 2) Compared with control group, the meta-analysis suggests oral levothyroxine tablets cannot effectively reduce the preterm delivery rate and the abortion rate. 3) Further subgroup analysis of the data according to the natural pregnancy group and assisted reproduction group found that oral levothyroxine tablets in natural pregnancy women with TAI can effectively reduce the preterm delivery rate ( RR=0.54, 95% CI=0.31-0.95, P=0.03), but not reduce the abortion rate ( RR=0.86, 95% CI=0.69-1.06, P=0.15). However, oral levothyroxine tablets cannot reduce the abortion rate for TAI women conceived by reproductive technology ( RR=0.80, 95% CI=0.47-1.36, P=0.41). Conclusion:Oral levothyroxine tablets can effectively reduce the premature delivery rate of TAI women who are naturally pregnant, but it is not beneficial to reduce the abortion rate. There is only one study on TAI women who are pregnant with reproductive technology, so it is impossible to evaluate whether this population can benefit from taking levothyroxine tablets. In view of the above results, it is recommended that the two groups of patients be managed separately.
