Meta Analysis Of The Effect Of Iodine-131 Treatment On Pregnancy Outcome After Thyroid Carcinoma Surgery

Background and objective:Thyroid carcinoma is the most common malignant tumor of endocrine.The incidence is increasing year by year.It occurs in women of childbearing age.The commonly treatment for differentiated thyroid carcinoma(DTC)is surgery+iodine 131 treatment+endocrine treatment.There are many studies to explore the effect of iodine 131 treatment on pregnancy outcomes after thyroid carcinoma surgery,But the outcomes were inconsistent.Thus,we performed this meta-analysis aimed to identify the correlation between iodine 131 treatment after thyroid carcinoma and pregnancy outcome.Methods:Electronic database the PubMed,Embase,Cochrane Library,CNKI,VIP,and Wanfang were throughly search to identify the observation studies which reported the correlation between iodine 131 treatment after thyroid carcinoma and pregnancy outcome up to December 2017.Two researchers independently screened the literature by inclusion and exclusion criteria and assessed the quality of the inclusion according Newcastle-Ottawa Quality Assessment Scale(NOS).Then the Statistical analysis was then performed through the Stata/SE 12.0 software,and a random effects model(P?0.1or I~2>50%)or fixed effects model(P>0.1 and I~2?50%)was adopted according to the result of heterogeneity test.Statistical results of the meta-analysis are shown in the forest diagram.The sources of heterogeneity are explored using sensitivity analysis and subgroup analysis.The Egger's and Begg's test methods are used to test the publication bias.The primary endpoint was pregnancy outcome,including spontaneous abortion,induced abortion,live birth,premature birth,stillbirth.Results:A total of 7 observational studies were enrolled,including 14212 participants and 3106 pregnancies.The number of pregnancies in the iodine 131 treatment group was 1939 cases and 1167 in the no iodine 131 treatment group.DTC postoperative iodine 131 treatment had no significant effect on spontaneous abortion(OR=1.05,P=0.703);induced abortion(OR=1.05,P=0.861);premature birth(OR=1.50,P=0.064);stillbirth(OR=0.63,P=0.406);abortion(OR=1.07,P=0.574);The risk of the abortion in the group which interval time of last 131I treatment and pregnancy>1 year was lower than<1 year(OR=0.52,P=0.000),the difference was statistically significant.The postoperative iodine 131 treatment dose greater than 3.7GBq and less than 3.7GBq group had no effect on abortion(OR=0.91,P=0.526).Conclusions:The risk of the abortion in the group which interval time of last 131I treatment and pregnancy>1 year was lower.The postoperative 131I treatment of DTC had no significant effect on the outcome of abortion,premature birth,and 131I treatment dose had no significant effect on abortion.Recommendations DTC patients should be avoided pregnancy within 1 year after iodine 131 treatment.