SynthesisFrontiers in pediatrics2025
Meta-analysis of the effects of levothyroxine therapy for subclinical hypothyroidism during pregnancy on offspring outcomes.
Synthesis in Frontiers in pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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.
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Who cites it
2 citing papers in PubMed.
- First-trimester thyroid reference intervals in twin pregnancy: establishment, diagnostic utility, and association with adverse outcomes.Frontiers in endocrinology · 2025Article
- Thyroid function in pregnant Saudi women: A cross-sectional study at a tertiary hospital.Journal of family & community medicineArticle
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: To conduct a systematic evaluation of the impact of levothyroxine (L-T4) therapy on birth outcomes in pregnancies complicated by subclinical hypothyroidism (SCH). Methods: A thorough literature review was conducted across several databases, including PubMed, Embase, Cochrane Library, Web of Science, Sinomed, Wanfang Data Knowledge Service Platform, China National Knowledge Internet (CNKI), and VIP Chinese Science and Technology Journal Database (VIP), to investigate the impact of L-T4 treatment of SCH during pregnancy on birth outcomes in offspring. Based on predefined inclusion and exclusion criteria, two researchers were appointed to extract data and assess the quality of the literature. Subsequently, meta-analysis was performed using RevMan 5.4 and Stata 14 software. Results: The study incorporated a total of thirty randomized controlled trials (RCTs) and cohort studies, encompassing four countries and regions. The sample included 18,568 pregnant women with SCH and 5,578 pregnant women undergoing L-T4 treatment. The meta-analysis indicated that L-T4 treatment for SCH during pregnancy may reduce the incidence of preterm birth (RCTs (RR = 0.56, 95% CI = 0.41-0.77), cohort studies (RR = 0.71, 95% CI = 0.51-0.99)) and low birth weight infants (LBWI) (RCTs (RR = 0.56, 95% CI = 0.35-0.89), cohort studies (RR = 0.71, 95% CI = 0.58-0.88)), while it does not significantly affect the risk of macrosomia (RCTs (RR = 0.29, 95% CI = 0.06-1.38), cohort studies (RR = 0.70, 95% CI = 0.30-1.62)), small for gestational age (SGA) infants (RCTs (RR = 1.18, 95% CI = 0.74-1.90)), or congenital hypothyroidism (CH) (cohort studies (RR = 1.27, 95% CI = 0.16-10.07)) in children. No significant difference in birth weight (RCTs (RR = 0.10, 95% CI = -0.04-0.24), cohort studies (RR = 0.10, 95% CI = -0.08-0.28)) was observed between the L-T4 treatment group and the non L-T4 treatment group. Regarding neonatal cord blood thyroid function, the TSH levels in the L-T4 treatment group were lower compared to the non L-T4 group (RCTs (RR = -2.48, 95% CI = -4.51--0.45), cohort studies (RR = -3.53, 95% CI = -4.27 - -2.79)); however, no significant differences were found in FT3 (RCTs (RR = 0.06, 95% CI = -0.24-0.36), cohort studies (RR = 0.08, 95% CI = -0.72-0.88)) and FT4 levels (RCTs (RR = 0.07, 95% CI = -0.41-0.56), cohort studies (RR = 0.03, 95% CI = -1.18-1.24)) between the two groups. Conclusion: L-T4 treatment appears to reduce the incidence of preterm birth and LBWI in pregnant mothers with SCH, but it does not significantly affect the incidence of macrosomia, SGA, CH, or birth weight. Regarding the thyroid function in neonatal umbilical cord blood, L-T4 treatment in SCH pregnant women can reduce TSH levels in the umbilical cord blood of their newborns, while having no significant effect on FT3 and FT4 levels. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251016450, PROSPERO CRD420251016450.
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