Thyroid Dysfunction in Children Exposed to Iodinated Contrast Media：A Meta-Analysis and Systematic Review

Objective Thyroid dysfunction is a known side effect of iodinated contrast media. There is some evidence to suggest that iodinated contrast media administered to pregnant women may cause thyroid dysfunction not only in themselves but also in their offspring. Here, we systematically evaluated literature on the use of iodinated contrast media prior to or during pregnancy on the offspring’s thyroid function. Design Systematic review of published literature. Materials and methods Relevant studies were identified by PubMed, EMBASE and The Cochrane Library up to June 5, 2020. All study designs, reporting on the foetal or neonatal thyroid function after exposure to iodinated contrast media prior to or during pregnancy, were included. We undertook random effects meta-analysis and pooled the estimates as proportions with 95% CIs. Results We identified 402 articles, of which 26 were included. Six studies reported (n = 369) on exposure to iodinated contrast media prior to pregnancy by hysterosalpingography and 20 studies (n = 670) on exposure to these media during pregnancy by amniofetography, urography or CT. There was low to high risk of bias. The proportion of (transient) neonatal thyroid dysfunction was 0.0% (95% CI: 0.0–2.9% based on 3 studies) for hysterosalpingography, 2.25% (95% CI: 0.03–6.55% based on 2 studies) for amniofetography and 0.0% (95% CI: 0.0–0.02% based on 5 studies) for CT. There was a tendency towards an increased risk of thyroid dysfunction with higher amounts of contrast used. Conclusions Exposure to iodinated contrast media prior to or during pregnancy may increase the risk of thyroid dysfunction in offspring. We recommend keeping the amount of contrast used as low as possible.

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Response to letter to the editor [from Idrees and Bianco]: (Treatment of Thyroid Dysfunction and Serum Lipids: A Systematic Review and Meta-Analysis)

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab228 ◽

2021 ◽

Author(s):

Anupam Kotwal ◽

M Hassan Murad ◽

Fares Alahdab

Keyword(s):

Systematic Review ◽

Serum Lipids ◽

Thyroid Dysfunction ◽

Meta Analysis ◽

Letter To The Editor

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Thyroid dysfunction in Iranian pregnant women: a systematic review and meta-analysis

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03040-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Farnaz Sepasi ◽

Tayebeh Rashidian ◽

Mehdi Shokri ◽

Gholamreza Badfar ◽

Fatemeh Kazemi ◽

...

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Thyroid Dysfunction ◽

Meta Analysis

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Subclinical thyroid dysfunction and depressive symptoms: protocol for a systematic review and individual participant data meta-analysis of prospective cohort studies

BMJ Open ◽

10.1136/bmjopen-2019-029716 ◽

2019 ◽

Vol 9 (7) ◽

pp. e029716

Author(s):

Lea Wildisen ◽

Elisavet Moutzouri ◽

Shanthi Beglinger ◽

Lamprini Syrogiannouli ◽

Anne R Cappola ◽

...

Keyword(s):

Systematic Review ◽

Depressive Symptoms ◽

Cohort Studies ◽

Prospective Cohort ◽

Thyroid Dysfunction ◽

Meta Analysis ◽

Individual Participant Data ◽

Prospective Cohort Studies ◽

Individual Participant

IntroductionProspective cohort studies on the association between subclinical thyroid dysfunction and depressive symptoms have yielded conflicting findings, possibly because of differences in age, sex, thyroid-stimulating hormone cut-off levels or degree of baseline depressive symptoms. Analysis of individual participant data (IPD) may help clarify this association.Methods and analysisWe will conduct a systematic review and IPD meta-analysis of prospective studies on the association between subclinical thyroid dysfunction and depressive symptoms. We will identify studies through a systematic search of the literature in the Ovid Medline, Ovid Embase, Cochrane Central Register of Controlled Trials (CENTRAL) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases from inception to April 2019 and from the Thyroid Studies Collaboration. We will ask corresponding authors of studies that meet our inclusion criteria to collaborate by providing IPD. Our primary outcome will be depressive symptoms at the first available individual follow-up, measured on a validated scale. We will convert all the scores to the Beck Depression Inventory scale. For each cohort, we will estimate the mean difference of depressive symptoms between participants with subclinical hypothyroidism or hyperthyroidism and control adjusted for depressive symptoms at baseline. Furthermore, we will adjust our multivariable linear regression analyses for age, sex, education and income. We will pool the effect estimates of all studies in a random-effects meta-analysis. Heterogeneity will be assessed by I2. Our secondary outcomes will be depressive symptoms at a specific follow-up time, at the last available individual follow-up and incidence of depression at the first, last and at a specific follow-up time. For the binary outcome of incident depression, we will use a logistic regression model.Ethics and disseminationFormal ethical approval is not required as primary data will not be collected. Our findings will have considerable implications for patient care. We will seek to publish this systematic review and IPD meta-analysis in a high-impact clinical journal.PROSPERO registration numberCRD42018091627.

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