Volume 15, Issue 9 (9-2017)                   IJRM 2017, 15(9): 543-552 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Parizad Nasirkandy M, Badfar G, Shohani M, Rahmati S, YektaKooshali M H, Abbasalizadeh S, et al . The relation of maternal hypothyroidism and hypothyroxinemia during pregnancy on preterm birth: An updated systematic review and meta-analysis. IJRM 2017; 15 (9) :543-552
URL: http://ijrm.ir/article-1-857-en.html
The relation of maternal hypothyroidism and hypothyroxinemia during pregnancy on preterm birth: An updated systematic review and meta-analysis
Marzieh Parizad Nasirkandy1 , Gholamreza Badfar2 , Masoumeh Shohani3 , Shoboo Rahmati4 , Mohammad Hossein YektaKooshali5 , Shamsi Abbasalizadeh1 , Ali Soleymani6 , Milad Azami * 7
1- Department of Obstetrics and Gynecology, Women’s Reproductive Health Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
2- Department of Pediatrics, Behbahan Faculty of Medical Sciences, Ahvaz Jundishapour University of Medical science, Behbahan, Iran
3- Department of Nursing, Faculty of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran
4- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
5- Student Research Committee, School of Nursing- Midwifery, and Paramedicine, Guilan University of Medical Sciences, Rasht, Iran
6- Faculty of Medicine, Dezful University of Medical Sciences, Dezful, Iran
7- Faculty of Medicine, Dezful University of Medical Sciences, Dezful, Iran. , MiladAzami@medilam.ac.ir
Abstract:   (3706 Views)
Background: The clinical consequences of hypothyroidism and hypothyroxinemia during pregnancy such as preterm birth are not still clear.
Objective: The aim of this meta-analysis was to estimate the relation of clinical and subclinical hypothyroidism and hypothyroxinemia during pregnancy and preterm birth.
Materials and Methods: In this meta-analysis, Preferred Reporting Items for Systematic review and Meta-Analysis were utilized. Searching the 83Tcohort studies83T were done by two researchers independently without any restrictions on Scopus, PubMed, Science Direct, Embase, Web of Science, CINAHL, Cochrane, EBSCO and Google Scholar databases up to 2017. The heterogeneity of the studies was checked by the Cochran's Q test and IP2P index. Both random and fixed-effects models were used for combining the relative risk and 95% confidence intervals. Data were analyzed using Comprehensive Meta-Analysis software version 2.
Results: Twenty-three studies were included in the meta-analysis. The relative risks of the clinical hypothyroidism, subclinical hypothyroidism and hypothyroxinemia during pregnancy on preterm birth was estimated 1.30 (95% CI: 1.05-1.61, p=0.013, involving 20079 cases and 2452817 controls), 1.36 (95% CI: 1.09-1.68, p=0.005, involving 3580 cases and 64885 controls) and 1.31 (95% CI: 1.04-1.66, p=0.020, involving 1078 cases and 44377 controls), respectively.
Conclusion: The incidence of preterm birth was higher among mothers with clinical and subclinical hypothyroidism or hypothyroxinemia during pregnancy compared to euthyroid mothers, and these relations were significant. Therefore, 83Tgynecologists and endocrinologists83T should manage these patients to control the incidence of 83Tadverse pregnancy outcomes83T such as preterm birth.
Keywords: Hypothyroidism, Pregnancy, Preterm birth, Meta-analysis, Cohort.
Full-Text [PDF 880 kb]   (1291 Downloads) |   |   Full-Text (HTML)  (664 Views)  
Type of Study: Original Article |
References
1. Laurberg P, Andersen SL, Pedersen IB, Andersen S, Carle A. Screening for overt thyroid disease in early pregnancy may be preferable to searching for small aberrations in thyroid function tests. Clin Endocrinol (Oxf) 2013; 79: 297-304. [DOI:10.1111/cen.12232]
2. Mullur R, Liu YY, Brent GA. Thyroid Hormone Regulation of Metabolism. Physiol Rev 2014; 94: 355-382. [DOI:10.1152/physrev.00030.2013]
3. Glinoer D. The regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology. Endocr Rev 1997; 18: 404-433. [DOI:10.1210/edrv.18.3.0300]
4. Karakosta P, Alegakis D, Georgiou V, Roumeliotaki T, Fthenou E, Vassilaki M, et al. Thyroid dysfunction and autoantibodies in early pregnancy are associated with increased risk of gestational diabetes and adverse birth outcomes. J Clin Endocrinol Metab 2012; 97: 4464-4472. [DOI:10.1210/jc.2012-2540]
5. Skjoldebrand L, Brundin J, Carlstrom A, Pettersson T. Thyroid associated components in serum during normal pregnancy. Acta Endocrinol (Copenh) 1982; 100: 504-511. [DOI:10.1530/acta.0.1000504]
6. Vaidya B, Anthony S, Bilous M, Shields B, Drury J, Hutchison S, et al. Detection of thyroid dysfunction in early pregnancy: Universal screening or targeted high-risk case finding? J Clin Endocrinol Metab 2007; 92: 203e7.
7. Negro R, Mestman JH. Thyroid disease in pregnancy. Best Pract Res Clin Endocrinol Metab 2011; 25: 927e43.
8. Allan WC, Haddow JE, Palomaki GE, Williams JR,Mitchell ML, Hermos RJ, et al. Maternal thyroid deficiency and pregnancy complications: implications for population screening. J Med Screen 2000; 7:127e30.
9. 66Tvan den Boogaard E66T, 66TVissenberg R66T, 66TLand JA66T, 66Tvan Wely M66T, 66TVen der Post JA66T, 66TGoddijn M66Tet all. Significance of (sub) clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy: a systematic review. 66THum Reprod Update66T 2016; 22: 532-533. [DOI:10.1093/humupd/dmw003]
10. Korevaar TI, Schalekamp-Timmermans S, de Rijke YB, Visser WE, Visser W, de Muinck Keizer-Schrama SM, et al. Hypothyroxinemia and TPO-antibody positivity are risk factors for premature delivery: the generation R study. J Clin Endocrinol Metab 2013; 98: 4382-4390. [DOI:10.1210/jc.2013-2855]
11. Ajmani SN, Aggarwal D, Bhatia P, Sharma M, Sarabhai V, Paul M. Prevalence of o vert and subclinical thyroid dysfunction among pregnant women and its effect on maternal and fetal outcome. J Obstet Gynaecol India 2014; 64: 105-110. [DOI:10.1007/s13224-013-0487-y]
12. Andersen SL, Olsen J, Wu CS, Laurberg P. Low birth weight in children born to mothers with hyperthyroidism and high birth weight in hypothyroidism, whereas preterm birth is common in both conditions: A danish national hospital register study. Eur Thyroid J 2013; 2: 135-144. [DOI:10.1159/000350513]
13. 66TLeón G66T, 66TMurcia M66T, 66TRebagliato M66T, 66TÁlvarez-Pedrerol M66T, 66TCastilla AM66T, 66TBasterrechea M66Tet all. 58TMaternalthyroiddysfunction58T during 58Tgestation58T, 58Tpretermdelivery58T, and 58Tbirthweight58T. The 58TInfanciay Medio Ambiente Cohort58T, 58TSpain58T. 66TPaediatr Perinat Epidemiol66T 2015; 29: 113-122.
14. 66TWikner BN66T, 66TSparre LS66T, 66TStiller CO66T, 66TKällén B66T, 66TAsker C66T. 58TMaternal58T use of 58Tthyroid hormones58T in 58Tpregnancy58T and 58Tneonataloutcome58T. 66TActa Obstet Gynecol Scand66T 2008; 87: 617-627.
15. Azami M, Nasirkandy MP, Mansouri A, Darvishi Z,Rahmati S, Abangah G, et al. Global Prevalence of Helicobacter pylori Infection in Pregnant Women: A Systematic Review and Meta-analysis Study. 93TInt J Women's Health Reprod Sci 2017; 5: 30-36. [DOI:10.15296/ijwhr.2017.06]
16. Mansouri A, Adhami Mojarad MR, Badfar G, Abasian L, Rahmati S, Kooti W, et al. Epidemiology of Toxoplasma gondii among blood donors in Iran: A systematic review and meta-analysis. Transfus Apher Sci 2017; 56: 404-409. [DOI:10.1016/j.transci.2017.03.011]
17. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015; 4: 1. [DOI:10.1186/2046-4053-4-1]
18. Vandenbroucke JP, Elm Ev, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration. PLoS Med 2007; 4: 1628. [DOI:10.1371/journal.pmed.0040297]
19. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557-560. [DOI:10.1136/bmj.327.7414.557]
20. Ades AE, Lu G, Higgins JP. The Interpretation of Random-Effects Meta-Analysis in Decision Models. Med Decis Making 2005; 25: 646-654. [DOI:10.1177/0272989X05282643]
21. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994; 50: 1088-1101. [DOI:10.2307/2533446]
22. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629-634. [DOI:10.1136/bmj.315.7109.629]
23. Sahu MT, Das V, Mittal S, Agarwal A, Sahu M. Overt and subclinical thyroid dysfunction among Indian pregnant women and its effect on maternal and fetal outcome. Arch Gynecol Obstet 2010; 281: 215-220. [DOI:10.1007/s00404-009-1105-1]
24. 66TKumar A66T, 66TAgarwal K66T, 66TGupta RK66T, 66TKar P66T. 58TObstetric outcome58T in 58Twomen58T with 58Thepatitis Cvirusinfection58T and 58Tthyroid dysfunction58T. 66TActa Obstet Gynecol Scand66T 2009; 88: 1133-1137.
25. Saki F, Dabbaghmanesh MH, Ghaemi SZ, Forouhari S, Ranjbar Omrani G, Bakhshayeshkaram M. Thyroid function in pregnancy and its influences on maternal and fetal outcomes. Int J Endocrinol Metab 2014; 12: e19378. [DOI:10.5812/ijem.19378]
26. Hirsch D, Levy S, Nadler V, Kopel V, Shainberg B, Toledano Y. Pregnancy outcomes in women with severe hypothyroidism. Eur J Endocrinol 2013; 169: 313-320. [DOI:10.1530/EJE-13-0228]
27. Mannisto T, Vaarasmaki M, Pouta A, Hartikainen AL, Ruokonen A, Surcel HM, et al. Perinatal outcome of children born to mothers with thyroid dysfunction or antibodies: a prospective population-based cohort study. J Clin Endocrinol Metab 2009; 94: 772-779. [DOI:10.1210/jc.2008-1520]
28. Wang S, Teng WP, Li JX, Wang WW, Shan ZY. Effects of maternal subclinical hypothyroidism on obstetrical outcomes during early pregnancy. J Endocrinol Invest 2012; 35: 322-325.
29. Cleary-Goldman J, Malone FD, Lambert-Messerlian G, Sullivan L, Canick J, Porter TF, et al. Maternal thyroid hypofunction and pregnancy outcome. Obstet Gynecol 2008; 112: 85-92. [DOI:10.1097/AOG.0b013e3181788dd7]
30. Casey BM, Dashe JS, Wells CE, McIntire DD, Byrd W, Leveno KJ, et al. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol 2005; 105: 239-245. [DOI:10.1097/01.AOG.0000152345.99421.22]
31. Su PY, Huang K, Hao JH, Xu YQ, Yan SQ, Li T, et al. Maternal thyroid function in the first twenty weeks of pregnancy and subsequent fetal and infant development: a prospective population-based cohort study in China. J Clin Endocrinol Metab 2011; 96: 3234-3241. [DOI:10.1210/jc.2011-0274]
32. Ong GS, Hadlow NC, Brown SJ, Lim EM, Walsh JP. Does the thyroid-stimulating hormone measured concurrently with first trimester biochemical screening tests predict adverse pregnancy outcomes occurring after 20 weeks gestation? J Clin Endocrinol Metab 2014; 99: E2668-2672. [DOI:10.1210/jc.2014-1918]
33. Chen LM, Du WJ, Dai J, Zhang Q, Si GX, Yang H, et al. Effects of subclinical hypothyroidism on maternal and perinatal outcomes during pregnancy: a single-center cohort study of a Chinese population. PloS One 2014; 9: e109364. [DOI:10.1371/journal.pone.0109364]
34. Lahoti SK, Toppo L. subclinical hypothyroidism and pregnancy outcomes. Ann Int Med Den Res 2015; 1: 324-326.
35. Nassie DI, Ashwal E, Raban O, Ben-Haroush A, Wiznitzer A, Yogev Y, et al. Is there an association between subclinical hypothyroidism and preterm uterine contractions? A prospective observational study. J Matern Fetal Neonat Med 2017; 30: 881-885. [DOI:10.1080/14767058.2016.1191065]
36. Hadar E, Arbib N, Krispin E, Chen R, Wiznitzer A, et al. First trimester thyroid stimulating hormone as an independent risk factor for adverse pregnancy outcome. Am J Obstet Gynecol 2017; 26: S435. [DOI:10.1016/j.ajog.2016.11.482]
37. Breathnach FM, Donnelly J, Cooley SM, Geary M, Malone FD. Subclinical hypothyroidism as a risk factor for placental abruption: Evidence from a low‐risk primigravid population. Aust N Z J Obstet Gynaecol 2013; 53: 553-560. [DOI:10.1111/ajo.12131]
38. 66THamm MP66T, 66TCherry NM66T, 66TMartin JW66T, 66TBamforth F66T, 66TBurstyn I66T. The 58Timpact58T of 58Tisolated maternal hypothyroxinemia58T on 58Tperinatal morbidity58T. 66TJ Obstet Gynaecol Can66T 2009; 31: 1015-1021. [DOI:10.1016/S1701-2163(16)34345-6]
39. Casey BM, Dashe JS, Spong CY, McIntire DD, Leveno KJ, Cunningham GF. Perinatal significance of isolated maternal hypothyroxinemia identified in the first half of pregnancy. Obstet Gynecol 2007; 109: 1129-1135. [DOI:10.1097/01.AOG.0000262054.03531.24]
40. Stagnaro-Green A. Thyroid antibodies and miscarriage: where are we at a generation later? J Thyroid Res 2011; 2011: 841949.
41. Challis JR, Lockwood CJ, Myatt L, et al. Inflammation and pregnancy. Reprod Sci 2009; 16: 206-215. [DOI:10.1177/1933719108329095]
42. Stagnaro-Green A. Maternal thyroid disease and preterm delivery. J Clin Endocr Metab 2009; 94: 21-25. [DOI:10.1210/jc.2008-1288]
43. Forhead AJ, Fowden AL. Thyroid hormones in fetal growth and prepartum maturation. J Endocrinol 2014; 221: R87-R103. [DOI:10.1530/JOE-14-0025]
44. 66TSheehan PM66T, 66TNankervis A66T, 66TAraujo Júnior E66T, 66TDa Silva Costa F66T. Maternal 58TThyroid58T Disease and Preterm Birth: Systematic Review and Meta-Analysis. 66TJ Clin Endocrinol Metab66T 2015; 100: 4325-4331. [DOI:10.1210/jc.2015-3074]
45. Hou J, Yu P, Zhu H, Pan H, Li N, Yang H, et al. The impact of maternal hypothyroidism during pregnancy on neonatal outcomes: a systematic review and meta-analysis. Gynecol Endocrinol 2016; 32: 9-13. [DOI:10.3109/09513590.2015.1104296]
46. 66TMaraka S66T, 66TOspina NM66T, 66TO'Keeffe DT66T, 66TEspinosa De Ycaza AE66T, 66TGionfriddo MR66T, et al. 58TSubclinical Hypothyroidism58T in 58TPregnancy58T: A 58TSystematic Review58T and 58TMeta-Analysis58T. 66TThyroid66T 2016; 26: 580-590.
47. Nazarpour, S, Ramezani Tehrani F, Simbar M, Azizi F. Thyroid dysfunction and pregnancy outcomes. 45TInt J Reprod BioMed 45T2015;45T 1345T: 387-396.
48. Torremante P, Flock F, Kirschner W. Free thyroxine level in the high normal reference range prescribed for nonpregnant women may reduce the preterm delivery rate in multiparous. J Thyroid Res 2011; 2011: 905734. [DOI:10.4061/2011/905734]
Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Designed & Developed by : Yektaweb