Subclinical hypothyroidism: levothyroxine reduces pregnancy loss

  • Nazarpour S & al.
  • Arch Gynecol Obstet
  • 10 Aug 2019

  • International Clinical Digest
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Takeaway

  • Levothyroxine (LT4) treatment is associated with reduced odds of pregnancy loss and higher live birth rates in women with subclinical hypothyroidism (SCH), according to a systematic review and meta-analysis.
  • Odds of preterm labor were higher vs euthyroid women.

Why this matters

  • The use of LT4 treatment to improve pregnancy outcomes for women with SCH is controversial.

Key results

  • LT4 was associated with reduced odds of overall pregnancy loss (OR, 0.78; 95% CI, 0.66-0.94) and abortion (OR, 0.37; 95% CI, 0.18-0.77) and improved live birth rates (OR, 2.72; 95% CI, 1.44-5.11) compared with placebo in women with SCH.
  • Women with SCH receiving LT4 had reduced odds of adverse neonatal complications (OR, 0.59; 95% CI, 0.36-0.99) vs euthyroid women, but higher odds of:
    • Preterm labor (OR, 1.82; 95% CI, 1.14-2.91).
    • Preterm/low-birth weight/oligohydramnios outcomes (OR, 1.74; 95% CI, 1.15-2.65).

Study design

  • 13 studies (6 randomised controlled trials, 7 cohort studies) with a total of 11,503 participants were included in the meta-analysis.
  • Funding: None.

Limitations

  • Heterogeneity between included studies.