Angiogenic factors and the risk of preeclampsia: A systematic review and meta-analysis

Background: The etiological nature of preeclampsia is heterogeneous. The use ofbiomarkers indices in early pregnancy helps to have appropriate stratification ofpregnancies into high- and low risk for the purpose of choosing timely interventions.Objective: The aim of this systematic review was to determine the pathogenic role ofsoluble soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) inthe prediction of preeclampsia in women.Materials and Methods: We performed a systematic search of the internationaldatabases including PubMed, Scopus, and Web of Science until August 2017. Thequality of included studies was assessed using the Newcastle-Ottawa Scale. Theprimary outcome in this review was preeclampsia. The statistical heterogeneity wasassessed using the X2 test and quantified by I2. Pooled effects size was obtained byrandom effects model. Subgroup analyses were also carried out.Results: Totally, 284 records were identified in the initial search and 15 records werefinally included in the meta-analysis. The pooled odds ratios (ORs) for the associationbetween the high level of sFlt-1 and low level of PlGF and subsequent developmentof preeclampsia among women were 5.20 (95% CI: 1.24–9.16) and 2.53 (95% CI: 1.33–3.75), respectively. The mean difference for sFlt-1 and PlGF in women with preeclampsiacompared to controls was 1.15 (95% CI: 0.43–1.86) and –0.94 (95% CI: –1.37–0.52),respectively.Conclusion: According to the results from this meta-analysis, increased levels of sFlt-1and reduced levels of PlGF predict the subsequent development of preeclampsia.

Keywords:

Angiogenic factors , Preeclampsia , sFLT-1 , PlGF