The ability of late pregnancy maternal tests to predict adverse pregnancy outcomes associated with placental dysfunction (specifically fetal growth restriction and pre-eclampsia): a protocol for a systematic review and meta-analysis of prognostic accuracy studies

Abstract

Background: Pre-eclampsia and being born small for gestational age are associated with significant maternal and neonatal morbidity and mortality. Placental dysfunction is a key pathological process underpinning these conditions; thus, markers of placental function have the potential to identify pregnancies ending in pre-eclampsia, fetal growth restriction, and the birth of a small for gestational age infant. Primary objective: To assess the predictive ability of late pregnancy (after 24 weeks' gestation) tests in isolation or in combination for adverse pregnancy outcomes associated with placental dysfunction, including pre-eclampsia, fetal growth restriction, delivery of a SGA infant (more specifically neonatal growth restriction), and stillbirth. Methods: Studies assessing the ability of biochemical tests of placental function and/or ultrasound parameters in pregnant women beyond 24 weeks' gestation to predict outcomes including pre-eclampsia, stillbirth, delivery of a SGA infant (including neonatal growth restriction), and/or fetal growth restriction will be identified by searching the following databases: EMBASE, MEDLINE, Cochrane CENTRAL, Web of Science, CINAHL, ISRCTN registry, UK Clinical Trials Gateway, and WHO International Clinical Trials Portal. Any study design in which the biomarker and ultrasound scan potential predictors have been assessed after 24 weeks' gestation but before diagnosis of outcomes (pre-eclampsia, fetal growth restriction, SGA (including neonatal growth restriction), and stillbirth) will be eligible (this would include randomized control trials and nested prospective case-control and cohort studies), and there will be no restriction on the background risk of the population. All eligible studies will be assessed for risk of

Optimization of pharmacotherapy of gestational hypertension

“…Hypertensive disorders during pregnancy are accompanied by a high frequency of obstetric and perinatal complications, the risk of which increases not only with increasing blood pressure (BP), but also with the period of time during which it existed and the effectiveness of treatment [4,7,12,15].…”

“…Pathological changes that occur in the placenta in hypertensive disorders lead to disturbances of maternal placental and fetal blood flow, decreased blood supply to the placenta and fetus, limited gas exchange and metabolism in the fetoplacental complex, as well as disruption of placental maturation. All this leads to the development of fetoplacental dysfunction and reduced endurance of the fetus to hypoxia [3,5,7,16].…”

Novel association between FOXO3 rs2232365 polymorphism and late-onset preeclampsia: a case-control candidate genetic study

“…Preeclampsia (PE) is a pregnancy-specific syndrome and associated with significant maternal and fetal morbidity and mortality [1]. PE averagely affects 6.7% of pregnant women globally and 4.2% individuals in China [2,3].…”

Novel Association Between FOXO3 rs2232365 Polymorphism and Late-Onset Preeclampsia: A Case-Control Candidate Genetic Study

“…Preeclampsia (PE is a pregnancy-speci c syndrome and associated with signi cant maternal and fetal morbidity and mortality. [1] PE averagely affects 6.7% of pregnant women globally and 10.6-11.5% individuals in low-and medium-income countries. [2] The pathogenesis of PE is multifactorial, with acknowledged contributions by genetic susceptibility, in ammatory stimuli, metabolic syndrome, oxidative stress, placental, and vascular dysfunction.…”