摘要目的 评价甲状腺自身免疫(TAI)状态对甲状腺功能(甲功)正常女性辅助生殖妊娠结局的影响.方法 以“甲状腺自身免疫”和“妊娠结局”相关的两组关键词,限定“辅助生育技术”进行计算机文献检索,文献来自Medline、Embase及Cochrane数据库,收集2014年5月10日之前发表的,有关TAI对女性辅助生殖妊娠结局影响的队列研究,剔除不符合研究设计要求的文献,应用RevMan 5.2软件录入数据,进行荟萃分析.结果 经检索和筛选后,11项合格的队列研究纳入本分析.结果显示,TAI对临床妊娠率无显著影响(RR =0.99,95％ CI:0.89～ 1.11,P=0.92),但与流产率升高相关(RR =1.54,95％ CI:1.24～ 1.92,P＜0.001).TAI组活产率/持续妊娠率虽然有降低趋势,但差异无统计学意义(RR=0.89,95％ CI:0.79 ～ 1.00,P=0.06).结论 在甲功正常的IVF女性中,TAI与流产风险增加相关,建议IVF妊娠的女性受孕后应尽早进行甲状腺疾病筛查.

abstractsObjective To investigate the association of thyroid autoimmunity (TAI) with pregnancy outcomes in euthyroid women undergoing in vitro fertilization (IVF).Methods The meta-analysis was a systematic review of cohort studies published before May 10th,2014.Data were retrieved from Medline,Embase and Cochrane library,and the keywords were "thyroid autoimmunity" and "pregnancy outcome",with restriction to artificial reproductive technique.RevMan 5.2 software was used for data analysis.Results In all,11 cohort studies met the inclusion criteria and were included in the meta-analysis.The results showed that TAI was not associated with clinical pregnancy rate (RR =0.99,95％ CI:0.89-1.11,P =0.92),but significantly associated with miscarriage risk (RR =1.54,95 ％ CI:1.24-1.92,P ＜ 0.001).Live birth/ongoing pregnancy rate decreased in the TAI group compared with the control group,but there was no statistically significant difference (RR =0.89,95％ CI:0.79-1.00,P =0.06).Conclusion As for euthyroid women who are receiving IVF,TAI contributes to increased risk of miscarriage.Therefore,we recommend universal screening for thyroid disease among women undergoing IVF.