ABSTRACT

Background

Utilities of the general population or expert estimates have been used for all published cost-effectiveness analyses of screening for thyroid disorders in pregnancy.

Methods

A systematic review CRD42019120897 of studies with patient-reported outcomes (PRO) and laboratory evidence of thyroid function/autoimmunity was conducted using PubMed, Cochrane Central, EconLit, SocIndex, DARE, NHS EEDS, Annual Reviews, and CINAHL. Quality was assessed using Joanna Briggs Institute appraisal tool.

Results

Of 664 abstracts screened, we analyzed 97 full texts. All studies describing the impact of thyroid disease on the generic QoL excluded pregnant and postpartum women. 21 reports of acceptable quality (321,850 pregnancies) determined depression and anxiety with validated tools and/or reported subjective symptoms. During pregnancy, contradictory conclusions were published on the impact of thyroid disease on PRO. Postpartum, antithyroid antibodies coincide with alexithymia and depression, postpartum thyroiditis negatively impacts mood. No conclusion could be drawn on the impact of thyroid hormonal levels.

Conclusions

The generic QoL in autoimmune thyroid disease during pregnancy has never been described, which represents an obstacle for the construction of economic models. We found contradictory information on the impact of thyroid disease on depression, anxiety, and specific symptoms.

中文翻译：

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妊娠期和产后自身免疫性甲状腺疾病女性的健康相关生活质量：包括 321,850 例妊娠的系统评价

摘要

背景

所有已发表的妊娠期甲状腺疾病筛查成本效益分析均使用了一般人群或专家估计的实用程序。

方法

使用 PubMed、Cochrane Central、EconLit、SocIndex、DARE、NHS EEDS、Annual Reviews 和 CINAHL 对具有患者报告结果 (PRO) 和甲状腺功能/自身免疫的实验室证据的研究进行了系统评价 CRD42019120897。使用 Joanna Briggs Institute 评估工具评估质量。

结果

在筛选的 664 篇摘要中，我们分析了 97 篇全文。所有描述甲状腺疾病对一般生活质量影响的研究都排除了孕妇和产后妇女。21 份质量可接受的报告（321,850 次怀孕）使用经过验证的工具和/或报告的主观症状确定了抑郁和焦虑。在怀孕期间，关于甲状腺疾病对 PR​​O 的影响发表了相互矛盾的结论。产后，抗甲状腺抗体与述情障碍和抑郁症同时发生，产后甲状腺炎对情绪产生负面影响。无法就甲状腺激素水平的影响得出结论。

结论

从未描述过妊娠期自身免疫性甲状腺疾病的一般生活质量，这对经济模型的构建构成了障碍。我们发现了关于甲状腺疾病对抑郁、焦虑和特定症状影响的相互矛盾的信息。