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Association between thyroid peroxidase antibody positivity and the risk of perinatal depression: a meta-analysis
Zixuan Feng1, Zixin Wu1, Jin Zhou1
1Department of Anesthesiology, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, China.
Insights
Thyroid peroxidase antibody (TPOAb) positivity is linked to a higher risk of perinatal depression (PND). This meta-analysis suggests a 1.52 times increased risk, highlighting a potential connection between autoimmune markers and maternal mental health.
Area of Science:
- Reproductive immunology
- Perinatal mental health
Background:
- Perinatal depression (PND) affects many women globally, posing risks to maternal and infant well-being.
- The link between thyroid peroxidase antibody (TPOAb) positivity and PND risk requires further clarification.
Purpose of the Study:
- To systematically evaluate the association between TPOAb positivity and the risk of developing PND.
Main Methods:
- A comprehensive meta-analysis of cohort, case-control, and cross-sectional studies was performed.
- Searches were conducted across major databases (PubMed, Web of Science, Embase, Cochrane Library, PsycINFO) up to March 1, 2025.
- Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS), and data were synthesized using random- and fixed-effects models.
Main Results:
- Eleven studies comprising 10,559 participants were included in the analysis.
- TPOAb-positive individuals showed a significantly elevated risk of PND (pooled RR=1.52, 95% CI [1.16-1.99], p<0.05).
- Moderate heterogeneity (I²=52%) was observed among the included studies.
Conclusions:
- Perinatal TPOAb positivity is associated with an increased risk of PND.
- Further high-quality prospective studies are recommended to confirm these findings and explore TPOAb timing during pregnancy.
Objectives:
Perinatal depression (PND) impacts a substantial subset of females globally and confers significant risk to maternal-infant health and offspring development, but current evidence on the association between thyroid peroxidase antibody (TPOAb) positivity and the risk of PND is uncertain. This study aims to evaluate the association between TPOAb positivity and the risk of PND.
Methods:
We systematically searched PubMed, Web of Science, Embase, the Cochrane Library, and PsycINFO from their inception to March 1, 2025. Cohort, case-control, and cross-sectional studies evaluating the association between TPOAb positivity and the risk of PND were included. This meta-analysis was conducted according to the PRISMA 2020 checklist. The risk of bias in the included studies was assessed by the Newcastle-Ottawa Scale (NOS). Data synthesis was performed using random-effects model and fixed-effects model.
Results:
After screening, 11 studies with 10,559 patients were eligible. The pooled relative risk (RR) indicated that females positive for TPOAb exhibited a significantly higher risk to develop PND (RR=1.52, 95 %CI [1.16-1.99], p<0.05). A moderate degree of heterogeneity was presented among the included studies (I2=52 %).
Conclusions:
This meta-analysis demonstrated that perinatal TPOAb positivity is associated with an increased risk of PND. However, given the moderate heterogeneity and the limited number of included studies, future well-designed prospective studies assessing TPOAb positivity at specific time points during pregnancy are warranted to improve the quality of evidence.
