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Early pregnancy biomarkers in pre-eclampsia: A systematic review and meta-analysis

Wu

Early pregnancy biomarkers in pre-eclampsia: A systematic review and meta-analysis Thumbnail


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Abstract

Pre-eclampsia (PE) complicates 2%–8% of all pregnancies and is an important cause of perinatal morbidity and mortality worldwide. In order to reduce these complications and to develop possible treatment modalities, it is important to identify women at risk of developing PE. The use of biomarkers in early pregnancy would allow appropriate stratification into high and low risk pregnancies for the purpose of defining surveillance in pregnancy and to administer interventions. We used formal methods for a systematic review and meta-analyses to assess the accuracy of all biomarkers that have been evaluated so far during the first and early second trimester of pregnancy to predict PE. We found low predictive values using individual biomarkers which included a disintegrin and metalloprotease 12 (ADAM-12), inhibin-A, pregnancy associated plasma protein A (PAPP-A), placental growth factor (PlGF) and placental protein 13 (PP-13). The pooled sensitivity of all single biomarkers was 0.40 (95% CI 0.39–0.41) at a false positive rate of 10%. The area under the Summary of Receiver Operating Characteristics Curve (SROC) was 0.786 (SE 0.02). When a combination model was used, the predictive value improved to an area under the SROC of 0.893 (SE 0.03). In conclusion, although there are multiple potential biomarkers for PE their efficacy has been inconsistent and comparisons are difficult because of heterogeneity between different studies. Therefore, there is an urgent need for high quality, large-scale multicentre research in biomarkers for PE so that the best predictive marker(s) can be identified in order to improve the management of women destined to develop PE.

Acceptance Date Sep 13, 2015
Publication Date Sep 23, 2015
Publicly Available Date Mar 28, 2024
Journal International Journal of Molecular Sciences
Print ISSN 1661-6596
Publisher MDPI
Pages 23035-23056
DOI https://doi.org/10.3390/ijms160923035
Keywords pre-eclampsia; early pregnancy biomarkers; meta-analysis
Publisher URL http://www.mdpi.com/1422-0067/16/9/23035

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