The risk of developing gestational diabetes mellitus in maternal subclinical hypothyroidism: a systematic review and meta-analysis

Purpose: The purpose of this study was to determine the association between maternal subclinical hypothyroidism (SCH) and gestational diabetes mellitus (GDM) risk.

Methods: This study is a systematic review and meta-analysis. Following PubMed, Medline, Scopus, Web of Science, and Google Scholar database search up to April 1 2021, a total of 4597 studies were identified. Studies published in English, with full text available, related to subclinical hypothyroidism in pregnancy, reporting or mentioning the incidence of GDM were included in the analysis. Following exclusion of studies, a total of 16 clinical trial were analyzed. For the risk of GDM, odds ratios (ORs) were calculated. Subgroup analyzes were performed according to gestational age and thyroid antibodies.

Results: Pregnant women with SCH were at increased risk of GDM compared to women with euthyroidism, overall (OR = 1.339, 95% CI 1.041-1.724; p = 0.023). Additionally, SCH without thyroid antibodies has no significant effect on GDM risk (OR = 1.173, 95% CI 0.88-1.56; p = 0.277) and pregnant women with SCH in the first trimester were not found to be at increased risk of GDM compared to women with euthyroidism regardless of thyroid antibodies (OR = 1.088, 95%CI 0.816-1.451; p = 0.564).

Conclusions: Maternal SCH in pregnancy is related to an increased risk of GDM.