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Early Pregnancy Biomarkers in Pre-Eclampsia: A Systematic Review and Meta-Analysis..pdf (2.47 MB)

Early Pregnancy Biomarkers in Pre-Eclampsia: A Systematic Review and Meta-Analysis

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posted on 2016-01-08, 10:13 authored by P. Wu, C. van den Berg, Z. Alfirevic, S. O'Brien, M. Röthlisberger, Philip Newton Baker, L. C. Kenny, K. Kublickiene, J. J. Duvekot
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.

History

Citation

International Journal of Molecular Sciences, 2015, 16 (9), pp. 23035-23056

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY

Version

  • VoR (Version of Record)

Published in

International Journal of Molecular Sciences

Publisher

MDPI

eissn

1422-0067

Acceptance date

2015-09-13

Copyright date

2015

Available date

2016-01-08

Publisher version

http://www.mdpi.com/1422-0067/16/9/23035

Language

en

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