Author(s): Chen L, Hu R
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Abstract OBJECTIVE: To investigate whether thyroid autoimmunity (TAI) is associated with increased risk of miscarriage in euthyroid women. METHODS: An electronic search was conducted using the databases Medline, PubMed, EMBASE and the Cochrane library, from inception to October 2010. A systematic review of the studies on the association between TAI and miscarriage was performed. The odd ratios of case-control studies and relative risks of cohort studies were pooled respectively. The software Review Manager (version 4.3.1) was applied for meta-analysis. RESULTS: The search strategy identified 53 potentially relevant publications, 22 of which were included in the meta-analysis. A clear association between thyroid autoimmunity and miscarriage was observed with a pooled odds ratio of 2·55 (95\% CI 1·42-4·57, P=0·002) in eight case-control studies and a pooled relative risk of 2·31 (95\% CI 1·90-2·82, P<0·000 01) in 14 cohort studies. Women with TAI were found to have slightly higher age [age difference, 1·29 years] (95\% CI 0·43-2·16, P=0·003) and thyroid-stimulating hormone (TSH) levels [TSH difference, 0·61 mIU/l] (95\% CI 0·51-0·71, P<0·000 01) compared with those without TAI. CONCLUSION: Based on the currently available evidence, it appears that the presence of thyroid autoimmunity is associated with an increased risk of spontaneous miscarriage in euthyroid women. © 2011 Blackwell Publishing Ltd.
This article was published in Clin Endocrinol (Oxf)
and referenced in Journal of Fertilization: In Vitro - IVF-Worldwide, Reproductive Medicine, Genetics & Stem Cell Biology