- In pregnant women with sub-clinical hypothyroidism (SCH), levothyroxine treatment is associated with a reduced risk for pregnancy loss and increased chances for live birth rate.
- These findings are not based on randomised controlled trials (RCTs) and should be interpreted with caution.
Why this matters
- SCH is associated with adverse pregnancy outcomes.
- There is still uncertainty regarding the prescription of levothyroxine therapy in preventing adverse outcomes.
- 13 studies (7 cohort studies and 6 RCTs) including 11,503 participants identified after a search across PubMed, Web of Science, Wiley, Google Scholar, ScienceDirect, and Scopus databases.
- Funding: None.
- Pregnant women with SCH treated with levothyroxine vs those treated with placebo had significantly:
- lower chances of pregnancy loss (OR, 0.78; 95% CI, 0.66-0.94; I2=0%; P<.05 and>
- higher chances of live birth rates (OR, 2.72; 95% CI, 1.44-5.11; I2=25%; P<.05>
- adverse maternal complications (OR, 1.038; 95% CI, 0.817-1.319),
- obstetrical haemorrhage (OR, 0.973; 95% CI, 0.575-1.644),
- preterm/low birth weight/oligohydramnios, (OR, 0.933; 95% CI, 0.821-1.061), and
- adverse neonatal complications (OR, 0.919; 95% CI, 0.734-1.150).
- No universal cut-off value for thyroid stimulating hormones in the diagnosis of SCH.