Key result
Maternal thyroid disorders during pregnancy linked to ~30% higher risk of fetal congenital heart disease.
Why the study?
The correlation between maternal thyroid disorders during pregnancy and the risk of fetal CHD needed evaluation.
Do maternal thyroid disorders and thyroid-related medication exposures during pregnancy increase the risk of fetal congenital heart disease?
Meta-Analysis
Do maternal thyroid disorders and thyroid-related medication exposures during pregnancy increase the risk of fetal congenital heart disease?
This meta-analysis demonstrates that maternal thyroid disorders and exposure to anti-thyroid drugs or levothyroxine during pregnancy are associated with a significantly elevated risk of fetal congenital heart disease, though certainty of evidence is low to very low.
Does not support changing thyroid management in pregnancy; leaves open whether targeted interventions could reduce CHD risk.
AIM: To evaluate whether thyroid disorders during pregnancy correlate with the risk of CHD. METHODS: Literature search was conducted across multiple databases, including PubMed/MedLine, Scopus, Cochrane Library, and grey literature repositories. Meta-analysis using a random-effect model was conducted. Newcastle-Ottawa Scale was used to determine the quality of studies. Grading of Recommendations, Assessment, Development, and Evaluations was used to evaluate the confidence in cumulative evidence. The study protocol was registered with the International Prospective Register of Systematic Reviews (CRD42024545867). RESULTS: A total of eight studies were included in the analysis. Maternal thyroid disorders were associated with the risk of CHDs (odd ratio 1.30, 95% confidence interval 1.07 to 1.57, P = 0.008). When categorised to specific subtypes, pooled studies reporting maternal hypothyroidism showed higher risk of developing CHD, even though it did not reach statistical significance (odds ratio 3.02, 95% confidence interval 0.57 to 16.05, P = 0.20). Exposure to maternal use of anti-thyroid drugs (odds ratio 4.44, 95% confidence interval 2.25 to 8.77, P < 0.0001) and levothyroxine (odds ratio 1.22, 95% confidence interval 1.08 to 1.37, P = 0.001) appeared to significantly increase the risk of CHD. All studies were judged to have good quality. The evidence generated from this study ranges from very low-to-low. CONCLUSION: Maternal thyroid disorders and exposure to thyroid-related medications appear to be associated with an elevated risk of CHD in fetuses.
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Mangkuliguna et al. (2026) conducted a meta-analysis in Fetal congenital heart disease (CHD) in pregnancies with maternal thyroid disorders. Maternal thyroid disorders (including hypothyroidism and exposure to anti-thyroid drugs or levothyroxine) vs. Pregnancies without maternal thyroid disorders or thyroid-related medication exposure was evaluated on Fetal congenital heart disease (CHD) (OR 1.30, 95% CI 1.07-1.57, p=0.008). Maternal thyroid disorders during pregnancy were associated with an increased risk of fetal congenital heart disease (OR 1.30, 95% CI 1.07-1.57, P=0.008).
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