左旋甲状腺素对妊娠期亚临床甲状腺功能减退症妊娠结局影响的荟萃分析

Effect of levothyroxine for pregnancy outcomes due to subclinical hypothyroidism during pregnancy:A meta-analysis

目的系统评价左旋甲状腺素(LT4)对亚临床甲状腺功能减退症(SCH)妊娠结局的影响。方法计算机检索文献,再根据相应的纳入和排除标准,筛选LT4对妊娠期亚临床甲状腺功能减退症随机对照试验,进行数据提取和质量评价后,应用Rev Man 5.3软件进行统计分析。结果本研究纳入14篇文献共包括患者3596例。LT4可以降低妊娠期高血压、妊娠期糖尿病、先兆子痫、产后出血、胎膜早破、贫血、早产、流产、新生儿窘迫、低出生体重儿的发生率,与对照组(未用LT4)比较,LT4组降低显著。结论LT4可以改善SCH孕妇妊娠并发症和新生儿不良结局的发生。

Objective To evaluate the effect of levothyroxine(LT4)for pregnancy outcomes in subclinical hypothyroidism(SCH)by meta-analysis.Methods Randomized controlled trials(RCT)of levothyroxine for pregnancy outcomes in SCH were searched from the computer databases according to the related inclusion and exclusion criteria.Following retrieval and quality evaluation,Rev Man 5.3 software was used for statistical analysis.Results A total of 14 literature including 3,596 patients were enrolled.LT4 reduced the incidence of gestational hypertension,gestational diabetes mellitus,pre-eclampsia,postpartum hemorrhage,premature rupture of membranes,anemia,premature delivery,abortion,neonatal distress,low birth weight infants.Compared with no LT4 use,the above items in LT4 group were lower significantly.Conclusion For pregnancy outcomes due to SCH,LT4 can decrease complications and incidence of adverse neonatal outcomes.