Prediction models for preeclampsia: A systematic review

Kat, Annelien C de; Hirst, Jane E; Woodward, Mark; Kennedy, Stephen; Peters, Sanne A.E.

doi:10.1016/j.preghy.2019.03.005

Cited by 111 publications

(107 citation statements)

References 68 publications

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“…In a recent systematic review of 68 models for predicting pre‐eclampsia or pre‐eclampsia‐related disorders from 70 studies with 425 125 participants, the most frequently used predictors were medical history, BMI, blood pressure, parity, uterine artery pulsatility index, and maternal age; however, the type of predictor (maternal characteristics, ultrasound markers, and/or biomarkers) was not clearly associated with model discrimination . In the present study, maternal age was found to be a predictor of HDP in the first pregnancy; however, BMI and parity were not predictors.…”

Section: Discussioncontrasting

confidence: 71%

Low antithrombin activity before delivery predicts subsequent hypertensive disorders in pregnancy

Morikawa

Umazume

Nakagawa

et al. 2019

Intl J Gynecology & Obste

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Objective To examine whether laboratory parameters can predict the onset of recurrent hypertensive disorders of pregnancy (HDP). Methods A retrospective study of 257 women with consecutive deliveries at a hospital in Sapporo, Japan, between 2009 and 2017. Women were divided into four groups according to whether or not they had HDP in the first and second peripartum periods (HDP‐HPD, HDP‐Non, Non‐HDP, Non‐Non). HDP was defined as gestational hypertension and/or proteinuria. Laboratory parameters measured on the day of or 1 day before delivery were compared between peripartum‐1 and peripartum‐2. Results Frequency of HDP in peripartum‐2 was higher among the 24 (9.3%) women with HPD in peripartum‐1 (6/24, 25.0%) than among the 233 (90.7%) women without (3/233, 1.3%) (P<0.001). In peripartum‐1, women with HDP had lower median antithrombin activity than those without (74% vs 89%, P=0.021). Antithrombin activity in peripartum‐1 was also lower in the HDP‐HDP (67%) than in the HDP‐Non (79%) group (P=0.021). Antithrombin activities of 77% or less at the first delivery predicted HDP in peripartum‐1 (P<0.001) and 70% or less predicted HDP in peripartum‐2 (P=0.018). Conclusion Women with HDP in peripartum‐1 had a higher incidence of HDP recurrence. Low antithrombin before a first delivery might predict recurrent HDP in a second pregnancy.

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Section: Discussioncontrasting

confidence: 71%

Low antithrombin activity before delivery predicts subsequent hypertensive disorders in pregnancy

Morikawa

Umazume

Nakagawa

et al. 2019

Intl J Gynecology & Obste

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“…According to a meta-analysis on the sFlt-1/PlGF ratio, which was recently considered one of the most promising serum markers in preeclampsia prediction, the authors found an overall sensitivity of 80%, a speci city of 92%, a positive likelihood ratio of 10.5 and a negative likelihood ratio of 0.22 after pooling 15 studies involving 534 cases and 19587 controls (20). A 4-week observation window along with the cutoff value of 38 was applied in the paper by Zeisler et al, which showed that the sFlt-1/PlGF ratio could accurately exclude preeclampsia occurrence in suspicious patients, with an AUC of 0.90 in the ROC analysis compared to an AUC of 0.67 in our study with follow-up until delivery (7); however, for the remaining markers included in present study, the observation window was yet to be well-de ned; delivery remained the mainstream endpoint in most of the preeclampsia prediction studies (5,21). The average interval between blood sampling and preeclampsia diagnosis was 7 weeks with our prospective cohort, which provided important clinical evidence for future validation studies.…”

Section: Discussioncontrasting

confidence: 53%

“…The total coe cients of variation (CVs) for PAPP-A2 and GlyFn were 4.1%-4.7% and 3.2-3.4%, respectively. The ELISA standard operation protocol was performed as previously described (5,18). The serum TM (HISCL ® TM Assay Kit, Japan, Sysmex) and tPAI-C (HISCL ® tPAI-C Assay Kit, Japan, Sysmex) levels were determined by the fully automated HISCL-5000 Chemiluminescence Analyzer (Japan, Sysmex Biotech) were also performed on the ARCHITECT ci16200 Analyzer (USA, Abbott).…”

Section: Serum Samples Reagents and Experimental Methodsmentioning

confidence: 99%

Predictive values of multiple serum biomarkers in women with suspected preeclampsia: a prospective study

Wang

Hu²,

Liu

et al. 2020

Preprint

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Background: Preeclampsia prediction improves maternal and fetal outcomes in pregnancy. We aimed to evaluate the preeclampsia prediction values of a series of serum biomarkers. Methods: Singleton pregnant women with preeclampsia-related clinical and/or laboratory presentations were recruited and had blood drawn at their first visits. The prospective cohort was further divided into preeclampsia-positive and preeclampsia-negative groups based on the follow-up results. The following markers were tested using the collected serum samples: soluble fms-like tyrosine kinase-1 ( sFlt-1); placental growth factor (PlGF); thrombomodulin (TM); tissue plasminogen activator inhibitor complex (tPAI-C); compliment factors C1q, B, and H; glycosylated fibronectin (GlyFn); pregnancy-associated plasma protein-A2 ( PAPP-A2); blood urea nitrogen (BUN); creatinine (Cre); uric acid (UA); and cystatin C (Cysc). Results: A total of 196 women with suspected preeclampsia were recruited with follow-up medical records. Twenty-five percent (n=49) of the recruited subjects developed preeclampsia before delivery, and 75% remained preeclampsia-negative (n=147). The serum levels of sFlt-1, BUN, Cre, UA, Cysc and PAPP-A2 were significantly elevated, and the PlGF level was significantly decreased in the preeclampsia-positive patients. In the receiver operating characteristics (ROC) analyses, the area under the curves were listed in the order of decreasing values: 0.73 (UA), 0.67 (sFlt-1/PlGF), 0.66 (Cysc), 0.65 (GlyFn/PlGF), 0.64 (PAPP-A2/PlGF), 0.63 (BUN), 0.63 (Cre), and 0.60 (PAPP-A2). With the cut-off values obtained from the ROC analyses, the positive predictive values of these serum markers were between 33.1% and 58.5%, and the negative predictive values were between 80.9% and 89.5%. Conclusions: Further studies are warranted to confirm the clinical utilities of the serum markers in preeclampsia prediction

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“…Risk stratification is essential in order to identify the subpopulation of pregnant women that would benefit from preventive measures early in the course of gestation, especially the administration of aspirin 9 . Recent research has proposed a variety of novel biomarkers as potential predictive tools, such as soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and placental growth factor (PlGF) 10 ; nevertheless, the optimal screening model to be widely used in clinical practice remains a matter of debate 11 …”

Section: Introductionmentioning

confidence: 99%

The prognostic role of serum uric acid levels in preeclampsia: A meta‐analysis

Bellos

Pergialiotis

Loutradis

et al. 2020

J of Clinical Hypertension

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This meta-analysis aims to compare serum uric acid levels among preeclamptic and healthy pregnant women across the various trimesters and provide a summary of the effect size of this biomarker in predicting adverse pregnancy outcomes. MEDLINE, Scopus, CENTRAL, Clinicaltrials.gov, and Google Scholar databases were systematically searched from inception. Observational studies were held eligible if they reported serum uric acid among preeclamptic and healthy pregnant women. Metaanalysis was conducted regarding uric acid concentration, diagnostic accuracy, and association with perinatal outcomes. The credibility of evidence was appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. The analysis included 196 studies, comprising 39 540 women.Preeclampsia was associated with significantly elevated uric acid levels during the 1st (mean difference [MD]: 0.21 mg/dL, 95% confidence intervals [CI]: 0.06-0.35) trimester, 2nd (MD: 1.41 mg/dL, 95% CI: 0.78-2.05) trimester, and 3rd (MD: 2.26 mg/dL, 95% CI: 2.12-2.40) trimester. Higher uric acid was estimated for severe preeclampsia, eclampsia, and hemolysis, elevated liver enzymes, low platelet syndrome. The sensitivity for adverse perinatal outcome prediction ranged from 67.3% to 82.7% and the specificity from 47.7% to 70.7%. In conclusion, it is suggested that serum uric acid levels are increased in preeclampsia and can be used to predict disease severity and pregnancy complications. Future prospective studies should verify these outcomes, assess the optimal cutoffs, and incorporate uric acid to combined predicting models. S U PP O RTI N G I N FO R M ATI O NAdditional supporting information may be found online in the Supporting Information section. How to cite this article: Bellos I, Pergialiotis V, Loutradis D, Daskalakis G. The prognostic role of serum uric acid levels in preeclampsia: A meta-analysis. J Clin Hypertens. 2020;22: 826-834. https://doi.

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Prediction models for preeclampsia: A systematic review

Cited by 111 publications

References 68 publications

Low antithrombin activity before delivery predicts subsequent hypertensive disorders in pregnancy

Low antithrombin activity before delivery predicts subsequent hypertensive disorders in pregnancy

Predictive values of multiple serum biomarkers in women with suspected preeclampsia: a prospective study

The prognostic role of serum uric acid levels in preeclampsia: A meta‐analysis

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