Evidence map›Paper›PMID 26837268›Full record

SynthesisThyroid : official journal of the American Thyroid Association2016

Subclinical Hypothyroidism in Pregnancy: A Systematic Review and Meta-Analysis.

Spyridoula Maraka, Naykky M Singh Ospina, Derek T O'Keeffe, Ana E Espinosa De Ycaza, Michael R Gionfriddo, Patricia J Erwin, Charles C Coddington, Marius N Stan, M Hassan Murad, Victor M Montori

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Thyroid : official journal of the American Thyroid Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 158 papers, 21 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
158citing papers in PubMed, 21 pooled it
27.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

158 citing papers in PubMed, 21 syntheses or guidelines pooled it, 404 citations in OpenAlex.

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  2. FIGO good practice recommendations on preconception care: A strategy to prevent preterm birth.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025
    Guideline
  3. Risk Factors for Thyroid Dysfunction in Pregnancy: An Individual Participant Data Meta-Analysis.Thyroid : official journal of the American Thyroid Association · 2024
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  18. Meta-analysis of ART outcomes in women with different preconception TSH levels.Reproductive biology and endocrinology : RB&E · 2018
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98 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Spyridoula Maraka1 Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic , Rochester, Minnesota.
Naykky M Singh Ospina1 Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic , Rochester, Minnesota.
Derek T O'Keeffe1 Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic , Rochester, Minnesota.
Ana E Espinosa De Ycaza1 Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic , Rochester, Minnesota.
Michael R Gionfriddo2 Knowledge and Evaluation Research Unit, Mayo Clinic , Rochester, Minnesota.
Patricia J Erwin4 Mayo Clinic Libraries, Mayo Clinic , Rochester, Minnesota.
Charles C Coddington5 Department of Obstetrics and Gynecology, Mayo Clinic , Rochester, Minnesota.
Marius N Stan1 Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic , Rochester, Minnesota.
M Hassan Murad2 Knowledge and Evaluation Research Unit, Mayo Clinic , Rochester, Minnesota.
Victor M Montori1 Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic , Rochester, Minnesota.
Mayo Clinic · USMayo Clinic in Florida · US

Funding

Mayo Clinic Center for Translational Science ActivitiesUL1TR000135 · NCATS · MAYO CLINIC ROCHESTER · PI KHOSLA, SUNDEEP · 2012 to 2015
$41.2M
NCATS NIH HHS UL1 TR000135
6 · The paper itself

Abstract

backgroundThe impact of subclinical hypothyroidism (SCH) and of levothyroxine replacement in pregnant women with SCH is unclear. The aims of this study were to assess (i) the impact of SCH during pregnancy on maternal and neonatal outcomes, and (ii) the effect of levothyroxine replacement therapy in these patients.

methodsOvid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, the Cochrane Controlled Trials Register, Ovid EMBASE, Web of Science, and Scopus were searched from inception to January 2015. Randomized trials and cohort studies of pregnant women with SCH that examined adverse pregnancy and neonatal outcomes were included. Reviewers extracted data and assessed methodological quality in duplicate. Eighteen cohort studies at low-to-moderate risk of bias were included. Compared with euthyroid pregnant women, pregnant women with SCH were at higher risk for pregnancy loss (relative risk [RR] 2.01 [confidence interval (CI) 1.66-2.44]), placental abruption (RR 2.14 [CI 1.23-3.70]), premature rupture of membranes (RR 1.43 [CI 1.04-1.95]), and neonatal death (RR 2.58 [CI 1.41-4.73]). One study at high risk of bias compared pregnant women with SCH who received levothyroxine to those who did not and found no significant decrease in the rate of pregnancy loss, preterm delivery, gestational hypertension, low birth weight, or low Apgar score.

conclusionsSCH during pregnancy is associated with multiple adverse maternal and neonatal outcomes. The value of levothyroxine therapy in preventing these adverse outcomes remains uncertain.

Indexed as

Abortion, SpontaneousFemaleHumansHypothyroidismPregnancyPregnancy ComplicationsPregnancy OutcomePremature BirthRisk AssessmentThyroxineTreatment OutcomeThyroxine

Identifiers

PMID26837268
PMCPMC4827301
OpenAlexW2292483019

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.