左甲状腺素钠片对妊娠合并甲状腺功能减退患者妊娠结局影响的Meta分析

Effect of Levothyroxine Sodium Tablets on Pregnancy Outcome in Patients with Pregnancy Complicated with Hypothyroidism: A Meta-analysis

目的:评价左甲状腺素钠对妊娠合并甲状腺功能减退患者用药有效性及妊娠结局的影响。方法:计算机检索PubMed、The Cochrane Library、Web of Science、EMBASE、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库(WanfangData)和维普医学数据库(VIP)辅以人工检索,检索时限均为建库至2019年4月。由2名研究者独立进行文献筛选、资料提取,采用Revman5.3软件进行Meta分析。结果:纳入15篇文献,共计3895例,经Meta分析结果显示:早产OR值[0.34,95%CI(0.25~0.45),P<0.001];流产OR值为[0.33,95%CI(0.23~0.47),P<0.001];妊娠高血压疾病OR值为[0.43,95%CI(0.31~0.61),P<0.001];产后出血OR值为[0.28,95%CI(0.19~0.43),P<0.001];胎盘早剥OR值为[0.48,95%CI(0.24~0.96),P<0.001];新生儿低体重OR值为[0.27,95%CI(0.16~0.44),P<0.001]。结论:左甲状腺素钠结合常规干预可以改善妊娠合并甲状腺功能减退患者的妊娠结局。

Objective:To evaluate the effect of levothyroxine sodium on the efficacy and pregnancy outcome of patients with pregnancy complicated with hypothyroidism. Methods :Computer search PubMed, The Cochrane Library、Web of Science、 EMBASE、 CBM、CNKI、 Wanfang Database、 and VIP supplemented by manual search, search the time limit is built until April 2019. Two researchers independently performed literature screening and data extraction, and meta analysis was performed using Revman 5.3 software. Results:A total of 3 895 patients were included in the literature. The results of meta-analysis showed that the premature OR value was[0.34, 95% CI (0.25-0.45), P< 0.001]. Abortion OR value was[ 0.33, 95% CI (0.23~0.47). P< 0.001]. OR value of gestational hypertension was [0.43, 95% CI (0.31~0.61), P< 0.001]. OR value of postpartum hemorrhage was [0.28, 95% CI (0.19~0.43), P< 0.001]. Placental abruption The OR value was [0.48, 95% CI (0.24~0.96), P< 0.001], and the neonatal low body weight OR value was [0.27, 95% CI(0.16~0.44), P< 0.001]. Conclusion:Levothyroxine sodium combined with conventional intervention can improve the thyroid function and reduce the incidence of adverse pregnancy in patients with hypothyroidism.