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Osinga, J A J, Derakhshan, A, Karachaliou, M, Poppe, K G, Warringa, L, Verdonk, K, Vaidya, B, Männistö, T, López-Bermejo, A, Bassols, J, Broeren, M A C, Brown, S J, Jensen, R C, Popova, P V, Pop, V J M, Feldt-Rasmussen, U, Aminorroaya, A, Bliddal, S, Mosso, L, Chatzi, L, Boucai, L, Itoh, S, Kishi, R, Kleynen, P, Ashoor, G, Oken, E, Grineva, E N, Lu, X, Lertxundi, A, Murcia, M, Meertens-Gunput, S T G, Rebagliato, M, Riaño-Galán, I, Irizar, A, Vrijheid, M, Fernández-Somoano, A, Suvanto, E, Guxens, M, Daraki, V, Mathieu, C, Kianpour, M, Glintborg, D, Jensen, T .... |
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Background: Pregnancy is a state of increased metabolic demand that necessitates major changes in endocrine physiology. Gestational thyroid dysfunction and gestational diabetes are common endocrine conditions of pregnancy that frequently coincide. Although the effects of thyroid hormones on glucose metabolism are well documented, important knowledge gaps remain in terms of the extent and clinical relevance of these effects during pregnancy. The aim of this meta-analysis is to assess the association of thyroid function test results with gestational diabetes and markers of glucose metabolism. Methods: In this systematic review and individual participant data meta-analysis, we searched Ovid MEDLINE, EMBASE, and Web of Science from database inception to Dec 12, 2024, for prospective population-based cohort studies with individual patient data on thyroid function, gestational diabetes, and measures of glucose homoeostasis during pregnancy. Furthermore, open invitations to join the Consortium on Thyroid and Pregnancy were issued to identify unpublished datasets. We excluded participants with multiple pregnancies; pre-existing thyroid disease or diabetes; current use of medications that could affect thyroid or glucose levels; or a history of infertility treatment, miscarriage, or stillbirth. Exposures were maternal gestational concentrations of thyroid-stimulating hormone (TSH), free T 4 (FT 4 ), free T 3 (FT 3 ), and total T 3 ; thyroperoxidase antibody positivity; thyroglobulin antibody positivity; and thyroid disease entities (ie, subclinical hypothyroidism, overt and subclinical hyperthyroidism, and isolated hypothyroxinaemia), which were defined according to current guidelines. The primary outcome was presence of gestational diabetes as defined in individual cohorts. Individual participant data were analysed using generalised linear mixed-effects regression models adjusting for maternal age, BMI, smoking status, parity, ethnicity, fetal sex, and gestational age at blood sampling. We preregistered our study ... |