Association between thyroid peroxidase antibody positivity and the risk of perinatal depression: a meta-analysis.

OBJECTIVES

Perinatal depression (PND) impacts a substantial subset of females globally and confers significant risk to maternal-infant health and offspring development, but current evidence on the association between thyroid peroxidase antibody (TPOAb) positivity and the risk of PND is uncertain. This study aims to evaluate the association between TPOAb positivity and the risk of PND.

METHODS

We systematically searched PubMed, Web of Science, Embase, the Cochrane Library, and PsycINFO from their inception to March 1, 2025. Cohort, case-control, and cross-sectional studies evaluating the association between TPOAb positivity and the risk of PND were included. This meta-analysis was conducted according to the PRISMA 2020 checklist. The risk of bias in the included studies was assessed by the Newcastle-Ottawa Scale (NOS). Data synthesis was performed using random-effects model and fixed-effects model.

RESULTS

After screening, 11 studies with 10,559 patients were eligible. The pooled relative risk (RR) indicated that females positive for TPOAb exhibited a significantly higher risk to develop PND (RR=1.52, 95 %CI [1.16-1.99], p<0.05). A moderate degree of heterogeneity was presented among the included studies (I2=52 %).

CONCLUSIONS

This meta-analysis demonstrated that perinatal TPOAb positivity is associated with an increased risk of PND. However, given the moderate heterogeneity and the limited number of included studies, future well-designed prospective studies assessing TPOAb positivity at specific time points during pregnancy are warranted to improve the quality of evidence.