Biomarkers and the Prediction of Adverse Outcomes in Preeclampsia: A Systematic Review and Meta-analysis.

Szczegóły
Abstrakt

Tytuł:: Biomarkers and the Prediction of Adverse Outcomes in Preeclampsia: A Systematic Review and Meta-analysis.
Autorzy:: Lim S; Department of Obstetrics and Gynaecology, Monash University, Monash Medical Centre, and Monash Women's, Monash Health, Clayton, Melbourne, Australia; and the Aberdeen Centre for Women's Health Research, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom.
Li W
Kemper J
Nguyen A
Mol BW
Reddy M
Źródło:: Obstetrics and gynecology [Obstet Gynecol] 2021 Jan 01; Vol. 137 (1), pp. 72-81.
Typ publikacji:: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Systematic Review
Język:: English
Imprint Name(s):: Publication: 2004- : Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: New York.
MeSH Terms:: Placenta Growth Factor/*blood
Pre-Eclampsia/*blood
Vascular Endothelial Growth Factor Receptor-1/*blood
Biomarkers/blood ; Female ; Humans ; Pre-Eclampsia/epidemiology ; Pregnancy
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Substance Nomenclature:: 0 (Biomarkers)
144589-93-5 (Placenta Growth Factor)
EC 2.7.10.1 (FLT1 protein, human)
EC 2.7.10.1 (Vascular Endothelial Growth Factor Receptor-1)
Entry Date(s):: Date Created: 20201205 Date Completed: 20210419 Latest Revision: 20210419
Update Code:: 20240104
DOI:: 10.1097/AOG.0000000000004149
PMID:: 33278298
: Czasopismo naukowe

Objective: To systematically review the performance of soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and the sFlt-1/PlGF ratio in predicting adverse outcomes in women with preeclampsia.
Data Sources: We performed a systematic search of MEDLINE, EMBASE, CINAHL, Cochrane, Scopus, ClinicalTrials.gov, and Emcare databases from 1989 to March 2019 to identify studies correlating sFlt-1, PlGF, and the sFlt-1/PlGF ratio with the occurrence of adverse outcomes in women with preeclampsia.
Methods of Study Selection: Two independent reviewers screened 3,194 studies using Covidence. Studies were included if they examined the performance of sFLT-1, PlGF, or the sFLT-1/PlGF ratio in predicting adverse outcomes in women with suspected or confirmed preeclampsia.
Tabulation, Integration, and Results: We extracted contingency tables with true-positive, false-positive, true-negative, and false-negative results. We calculated sensitivity, specificity, diagnostic odds ratios, and area under the summary receiver operating characteristic curve (area sROC) through a bivariate mixed-effects meta-analysis. Our literature search identified 3,194 articles, of which 33 (n=9,426 patients) were included. There was significant variation in the included studies with regard to the biomarkers and outcomes assessed. As such, few studies (n=4-8) were included in the meta-analysis component with significant heterogeneity between studies (I2=33-99). Nonetheless, both PlGF and the sFlt-1/PlGF ratio demonstrated area sROC values between 0.68 and 0.87 for the prediction of composite adverse maternal and perinatal outcomes, preterm birth and fetal growth restriction.
Conclusion: Placental growth factor and the sFlt-1/PlGF ratio show prognostic promise for adverse outcomes in preeclampsia, but study heterogeneity limits their clinical utility.
Systematic Review Registration: PROSPERO, CRD42019136207.
Competing Interests: Financial Disclosure Ben Willem Mol disclosed that money was paid to him from ObsEva, Guerbet, Merck, and iGenomix. The other authors did not report any potential conflicts of interest.
(Copyright © 2020 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)

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