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https://hdl.handle.net/2440/129994
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Type: | Journal article |
Title: | Biomarkers and the prediction of adverse Ooutcomes in preeclampsia: a systematic review and meta-analysis |
Author: | Lim, S. Li, W. Kemper, J. Nguyen, A. Mol, B.W. Reddy, M. |
Citation: | Obstetrics and Gynecology, 2021; 137(1):72-81 |
Publisher: | Lippincott, Williams & Wilkins |
Issue Date: | 2021 |
ISSN: | 0029-7844 1873-233X |
Statement of Responsibility: | Sean Lim, Wentao Li, Jessica Kemper, Andrew Nguyen, Ben Willem Mol, Maya Reddy |
Abstract: | 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.<h4>Data sources</h4>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.<h4>Methods of study selection</h4>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.<h4>Tabulation, integration, and results</h4>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.<h4>Conclusion</h4>Placental growth factor and the sFlt-1/PlGF ratio show prognostic promise for adverse outcomes in preeclampsia, but study heterogeneity limits their clinical utility. |
Keywords: | Humans Pre-Eclampsia Vascular Endothelial Growth Factor Receptor-1 Pregnancy Female Biomarkers Placenta Growth Factor |
Rights: | © 2020 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved. |
DOI: | 10.1097/aog.0000000000004149 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/1082548 http://purl.org/au-research/grants/nhmrc/1151281 |
Published version: | http://dx.doi.org/10.1097/aog.0000000000004149 |
Appears in Collections: | Aurora harvest 8 Obstetrics and Gynaecology publications |
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