Antithyroid drug use during pregnancy and the risk of birth defects in offspring: systematic review and meta‐analysis of observational studies with methodological considerations

ABSTRACTBackgroundMaternal anti-thyroid drug (ATD) use during the first trimester of pregnancy has been associated with an increased risk of birth defects in offspring. Uncertainty remains on the size of this risk and how it compares to untreated hyperthyroidism due to methodological limitations of previous studies.MethodsSystematic review of MEDLINE and EMBASE identifying observational studies examining ATD use during the first trimester of pregnancy and risk of birth defects. Data were extracted on study characteristics, adjusted effect estimates and comparator groups. Effect estimates were pooled using a random-effects generic inverse variance method of analysis and absolute risk calculated.ResultsSeven cohort studies and one case–control study (involving 6212322 pregnancies and 388976 birth defects) were identified. Compared to unexposed women without hyperthyroidism, the association between ATD first trimester use and birth defects in offspring was: adjusted risk ratio [aRR] 1.16 95% CI 1.08-1.25 for propylthyoruacil (PTU); aRR 1.28 95% CI 1.06-1.54 for methimazole/carbimazole (MMI/CMZ); aRR 1.51, 95% CI 1.16-1.97 for both MMI/CMZ and PTU; and aRR 1.15 95%CI 1.02-1.29 for untreated hyperthyroidism. The risk of major birth defects per 1000 live births was: 9.6 for PTU; 16.8 for MMI/CMZ; 30.6 for both MMI/CMZ and PTU; and 9.0 for untreated hyperthyroidism.ConclusionsWhen appropriately analysed this risk of birth defects associated with ATD use in the first trimester of pregnancy is attenuated. Although still elevated, the risk of birth defects is smallest with PTU compared to use of MMI/CMZ and may be similar to that of untreated hyperthyroidism.

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Non-steroidal anti-inflammatory drug use and risk of endometrial cancer: A systematic review and meta-analysis of observational studies

Gynecologic Oncology ◽

10.1016/j.ygyno.2015.12.009 ◽

2016 ◽

Vol 140 (2) ◽

pp. 352-358 ◽

Cited By ~ 35

Author(s):

Freija Verdoodt ◽

Søren Friis ◽

Christian Dehlendorff ◽

Vanna Albieri ◽

Susanne K. Kjaer

Keyword(s):

Systematic Review ◽

Endometrial Cancer ◽

Drug Use ◽

Observational Studies ◽

Meta Analysis ◽

Inflammatory Drug ◽

Anti Inflammatory

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The association between dietary inflammatory index and risk of central obesity in adults: An updated systematic review and meta-analysis

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000648 ◽

2020 ◽

Vol 90 (5-6) ◽

pp. 535-552 ◽

Cited By ~ 2

Author(s):

Mahdieh Abbasalizad Farhangi ◽

Mahdi Vajdi

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Central Obesity ◽

Assessment Tool ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Dietary Factors ◽

Cross Sectional ◽

Inflammatory Status ◽

Obesity Indices

Abstract. Backgrounds: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn’t evaluate the association between central obesity and dietary inflammation index (DII®) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII® with central obesity indices in the general populations. Methods: In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII® and indices of central obesity including WC or WHR were included. Results: Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII® scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785–2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95–1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. Conclusion: The findings proposed that adherence to diets with high DII® scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII® and central obesity indices.

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