[Obstetrical complications of thyroid peroxidase antibody positive during pregnancy and effects of intervention: a meta-analysis].

To explore the correlation between thyroid peroxidase antibody(TPOAb)and outcomes during pregnancy and the effects of treatment on outcomes.PubMed, Cochrane Library, Science Direct, Embase, Chinese Biomedicine, and Wanfangdata had been searched. Case-control and cohort studies about TPOAb and pregnancy outcomes were searched according to the inclusion and exclusion criteria. Fifty studies were finally recruited(all of cohort-studies, 10 for English and 5 for Chinese). Review Manager 5.3 were used to test the heterogeneity of the results among the different studies and amalgamate the effect size using fixed or random effect models.Meta-analysis showed TPOAb(+)with normal thyroid function increase the risks of miscarriage,and premature delivery, OR calculated were 2.02(95%CI: 1.13-3.62, P=0.001)and 1.39(95%CI: 1.11-1.76, P=0.005), while showed no relative risk to hypertensive disease, placental abruption in pregnancy and fetal growth restriction, OR calculated were 1.29(95%CI: 1.00-1.67, P=0.080), 0.42(95%CI: 0.12-1.43, P=0.210)and 1.61(95%CI: 0.23-11.12, P=0.100). TPOAb(+)with normal thyroid function increase miscarriage in in vitro fertilization and embryo transfer(IVF-ET), OR calculated were 2.14(95%CI: 1.43-3.21, P=0.000). Levothyroxine(LT4)for patients of TPOAb(+)with normal thyroid dysfunction decrease adverse obstetric outcomes, OR calculated were 0.43(95%CI: 0.22-0.85, P=0.020).TPOAb(+)with normal thyroid function increase the risks of miscarriage,and premature delivery. TPOAb(+)with normal thyroid function increase miscarriage in IVF-ET. LT4 for patients of TPOAb(+)with normal thyroid dysfunction decrease adverse obstetric outcomes.