Risk Factors for Thyroid Dysfunction in Pregnancy: An Individual Participant Data Meta-Analysis
Authors' conclusion
The risk factors assessed in this study had poor predictive ability for detecting thyroid function test abnormalities, questioning their clinical usability for targeted screening. As expected, TPOAb positivity (used as a benchmark) was a relevant risk factor for (subclinical) hypothyroidism.
Study context
- Population
- Pregnant women in prospective cohorts with gestational thyroid function data; excluded pre-existing thyroid disease and thyroid interfering medication
- Participants
- 65,559 women25 cohorts
- Comparison
- Risk factors for gestational thyroid dysfunction
- Outcome
- Overt and subclinical hypothyroidism and a treatment indication (overt hypothyroidism, SCH with thyrotropin >10 mU/L, or SCH with TPOAb positivity)
Methodological detailsmixed-effects regression models
- Mixed-effects regression models
Pooled result
As reported in the abstract
P < 0.001
- Screening rate in cohorts using currently recommended risk factors (age >30 years, parity ≥2, BMI ≥40)
- 58%
- Detection rate for overt and subclinical hypothyroidism with recommended risk factors
- 59%
- Absolute risk for overt or subclinical hypothyroidism varied over full range of age and BMI and for any parity
- <2%
- AUC for primary outcomes (age, BMI, smoking, parity, gestational age at sampling)
- 0.58 to 0.63
Further pooled results
Subclinical hypothyroidism by antibody status — Isolated TgAb positivity vs Antibody negativity · association across antibody categories
P < 0.001
Treatment indication by antibody status — Isolated TgAb positivity vs Antibody negativity · association across antibody categories
P < 0.001
Overt hyperthyroidism: twin vs singleton pregnancy
- Twin pregnancy associated with higher risk of overt hyperthyroidism (5.6% vs. 0.7%)
- P < 0.001
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →