Plain language summary
Gestational diabetes mellitus (GDM) is a common complication during pregnancy, characterised by glucose intolerance that develops during pregnancy. It poses risks not only to maternal health but also to foetal development. The primary aim of this study was to systematically evaluate and compare thyroid function (TF) and cardiac function (CF) between women with normal pregnancies and those diagnosed with gestational diabetes mellitus. This research is a meta-analysis that synthesises data from ten studies. There were 2554 subjects participating in these studies, including 1125 GDM patients. Results showed that: - women with GDM exhibited higher levels of thyroid-stimulating hormone and free triiodothyronine (FT3) compared to those with normal pregnancies. - free thyroxine (FT4) levels were significantly lower in the GDM group. Additionally, CF analysis revealed that women with GDM had: - lower left ventricular ejection fraction. - lower E/A ratio [to assess cardiac function], indicating impaired diastolic function. - higher E/E' ratio [to assess cardiac function], suggesting increased left ventricular filling pressures. Authors concluded that there is significant thyroid dysfunction and cardiac dysfunction in GDM patients, and these three clinical conditions interact with each other, further increasing the risk of adverse events during pregnancy.
Abstract
OBJECTIVE This is a meta-analysis of thyroid function (TF) and cardiac function (CF) differences between women with normal pregnancies and gestational diabetes mellitus (GDM), in order to provide more reliable reference and guidance for the future clinical prevention and treatment of GDM. METHODS Studies on the correlation of GDM with TF and CF were searched in PubMed, Cochrane Library, and other literature databases, and the literature for final analysis was confirmed after screening according to the eligibility criteria. Authors, publication time, research subjects, and endpoints were extracted for meta-analysis using Review 5.3 software. RESULTS After screening, 10 studies with a total of 2554 subjects were selected, including 1125 GDM patients (GDM group) and 1429 normal pregnant women (control group). All the included papers scored 6-7 points on the Newcastle-Ottawa Scale used for literature quality evaluation, implying high-quality research. In the meta-analysis, the relationship between GDM and TF, TSH, and FT3 increased evidently in the GDM group, while FT4 decreased (P < .05). The meta-analysis of GDM and CF revealed lower LVEF and E/A while higher E/E' in GDM patients compared to the controls (P < .05). The funnel plot showed that the graphs of all the endpoints were basically symmetrical, indicating low publication bias. CONCLUSION Given the obvious thyroid dysfunction and cardiac dysfunction in GDM patients, symptomatic intervention measures should be taken actively and timely to improve the safety of GDM patients during pregnancy.
Methodological quality
Jadad score
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Not applicable
Allocation concealment
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