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The effect of I-131 therapy on pregnancy outcomes after thyroidectomy in patients with differentiated thyroid carcinoma: a meta-analysis

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Abstract

Purpose

Studies on the effects of I-131 therapy on pregnancy outcomes after differentiated thyroid carcinoma (DTC) surgery showed inconsistent findings. The purpose of the study was to investigate the association between I-131 therapy and pregnancy outcomes in female DTC patients.

Methods

PubMed, Embase, Cochrane Library, CNKI, and VIP were searched until November, 2020. Keywords included differentiated thyroid cancer, thyroid carcinoma, thyroid neoplasm, radioiodine, I-131, 131I, pregnancy outcomes, reproduction, fertility, abortion, preterm birth, and congenital malformation. Studies that provided the pregnancy outcomes in DTC patients who received I-131 therapy and those who did not receive I-131 therapy were included. Meta-analysis was performed in Stata/SE 12. A random or fixed effects model was adopted according to the result of heterogeneity test.

Results

Seven observational studies were eligible, involving 125,591 participants and 13,811 pregnancies. It showed that postoperative I-131 therapy for DTC had no significant effect on spontaneous abortion (OR = 1.05, P = 0.701), induced abortion (OR = 1.06, P = 0.859), abortion (OR = 1.07, P = 0.098), premature birth (OR = 1.02, P = 0.756), stillbirth (OR = 1.58, P = 0.364), and congenital malformation(OR = 1.00, P = 0.986). Cumulative RAI dose >3.7 GBq or <3.7 GBq had no significant effect on abortion (OR = 0.94, P = 0.252) and congenital malformation (OR = 1.05, P = 0.752).The group in which interval time between last I-131 therapy and pregnancy >1 year had significant lower risk of abortion than with interval <1 year (OR = 0.60, P = 0.000).

Conclusions

Pregnancy is not recommended for DTC patients within 1 year after I-131 therapy.

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Acknowledgements

We thank the authors of the studies included this paper for their response to the requests for additional information.

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Author notes

  1. These authors contributed equally: Lijuan Zhang, Yinqiong Huang

Authors and Affiliations

  1. Department of Endocrinology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian, China

    Lijuan Zhang, Yinqiong Huang, Yuanyuan Zheng, Liangchun Cai, Junping Wen & Gang Chen

  2. Fujian Provincial Key Laboratory of Medical Analysis, Fujian Academy of Medical, Fuzhou, Fujian, China

    Gang Chen

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Contributions

L.Z. and Y.H. contributed to the study equally. L.Z. and Y.H. performed the data acquisition, analysed the data, wrote and revised the paper and approved the submitted version. G.C. designed the studies, revised the paper, and approved the submitted version. Y.Z., L.C. and J.W. revised the paper and approved the submitted version.

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Correspondence to Gang Chen.

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Zhang, L., Huang, Y., Zheng, Y. et al. The effect of I-131 therapy on pregnancy outcomes after thyroidectomy in patients with differentiated thyroid carcinoma: a meta-analysis. Endocrine 73, 301–307 (2021). https://doi.org/10.1007/s12020-021-02657-6

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