调整左旋甲状腺素治疗剂量对甲状腺功能减退孕妇母婴结局影响的meta分析
陈惠, 朱唯一, 姚屹瑾

A meta-analysis of the effects of levothyroxine dose adjustment on maternal and infant outcomes in pregnant women with hypothyroidism
CHEN Hui, ZHU Weiyi, YAO Yijin
表1 纳入研究基本特征
Tab 1 Basic characteristics of the studies
First authorYear of publica-tionNationNumber of cases/nAge/yearInterventionPrimary outcome index
ExpConExpConExpCon
GAO[8]2021China463425.3±3.424.8±3.1Guidance on routine maternal care was given. The initial dose of L-T4 was 50 μg/d. TSH level was re-examined 2 weeks later and the dose was adjustedGuidance on routine maternal care was given. The iodized salt was increased and the fat was reduced in the dietGH, PH, GDM, PD
YE[9]2016China282822-3422-34The fat was reduced, and the iodized salt and the protein were increased in the diet. Routine medication and nursing interventions were given. TSH was checked every 4‒6 weeks and the L-T4 dose was adjusted

The fat was reduced, and the iodized salt and the protein were increased in the diet. Routine medication and nursing interventions

were given

GDM, GH, DM, LBW, FD, NA
MA[10]2020China424228.74±4.0828.25±4.15The fat was reduced, and the iodized salt and the protein were increased in the diet. TSH level was checked once a month and the L-T4 dose was adjusted

The fat was reduced, and the iodized salt and the protein were increased in the diet. The dose of

L-T4 was 50 μg/d

GH, GDM, FD, PD, NA, LBW, DM, abortion
LIU[11]2021China494926.9±4.626.8±4.7The fat was reduced, and the iodized salt and the protein were increased in the diet. TSH level was checked termly and the L-T4 dose was adjusted

The fat was reduced, and the iodized salt and the protein were increased in the diet. The dose of

L-T4 was 25 μg/d

DM, FD, abortion, PD, NA, LBW
CASEY[12]2017America33933827.7±5.727.3±5.7

The initial dose of L-T4 was

100 μg/d. TSH level was checked once a month and the L-T4 dose was adjusted. TSH level was controlled in the range of

0.1‒2.5 mIU/L

A placebo of 100 μg was given daily with a dummy adjustmentGDM, GH, LBW, PD, FD
BLUMENTHAL[13]2017Australia9293333.47±1.4135.00±5.20

The iodized salt was increased in the diet. The dose of L-T4 was

50 μg/d when TSH>2.5 mIU/L. TSH was checked every 4 weeks and the L-T4 dose was adjusted

The iodine was increased in diet and L-T4 was not givenDM, GH, GDM, PD, FD
WANG[14]2012China28168Not mentioned28.14±0.27

The initial dose of L-T4 depended on the pregnant woman′s TSH level.

TSH 2.5‒5 mIU/L: L-T4 50 μg/d; TSH >5‒8 mIU/L: L-T4 75 μg/d; TSH>8 mIU/L: L-T4 100 μg/d. TSH level was checked every 4 weeks and the L-T4 dose was adjusted

L-T4 was not givenGH, PD, LBW, PH, abortion, NA
JU[15]2016China18427329.31±3.3628.88±3.53The initial LT-4 dose was determined based on TSH level. Dose of LT-4 was adjusted according to the treatment objective of TSHL-T4 was not givenGDM, GH, PH, PD, LBW