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Association of thyroid function test abnormalities with preeclampsia: a systematic review and meta-analysis
Mahboubeh Hajifoghaha1, Saeed Hosseini Teshnizi2, Sedighe Forouhari3
1Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
BMC Endocrine Disorders
|September 26, 2022
Summary
Preeclampsia is linked to significant thyroid function test abnormalities, with higher TSH and lower T4 and T3 levels observed. Early thyroid function testing in preeclamptic women is recommended to prevent thyroid disorders.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Perinatology
Background:
- Preeclampsia poses a significant risk to maternal and fetal health, potentially impacting multiple organs.
- Thyroid function abnormalities in preeclampsia can complicate diagnostic testing and patient management.
- Assessing thyroid function in preeclampsia is crucial for accurate prognostication and intervention.
Purpose of the Study:
- To conduct a meta-analysis evaluating thyroid function test (TFT) abnormalities in women with preeclampsia.
- To synthesize evidence on the relationship between preeclampsia and thyroid hormones: TSH, T4, T3, and FT3.
- To determine the clinical significance of TFT alterations in preeclampsia.
Main Methods:
- Systematic literature search of MEDLINE/PubMed, Scopus, Web of Science, and Google Scholar databases up to August 31, 2021.
- Inclusion of English observational studies comparing TFTs in normal pregnant women versus preeclamptic women.
- Quality assessment using the Newcastle-Ottawa Scale and evidence grading via the GRADE approach.
Main Results:
- Meta-analysis of 63 studies involving 21,528 participants revealed significantly higher TSH levels in preeclamptic women (SMD = 1.70).
- Preeclamptic women exhibited significantly lower total T4 (TT4) (SMD = -0.82), total T3 (TT3) (SMD = -0.88), and free T3 (FT3) (SMD = -0.59) levels.
- No significant difference in free T4 (FT4) levels was observed between preeclamptic and normotensive pregnant women (SMD = 0.002).
- Publication bias and sensitivity analyses confirmed the robustness of the findings, with GRADE assessing evidence quality as moderate to very low.
Conclusions:
- Preeclamptic women demonstrate a higher risk of thyroid function test abnormalities.
- The study recommends routine thyroid function testing for women diagnosed with preeclampsia.
- Monitoring TFTs can aid in managing potential thyroid disorders associated with preeclampsia.
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