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Abnormal blood biomarkers in early pregnancy are associated with preeclampsia: a meta-analysis

Rebecca E Allen1, Ewelina Rogozinska2, Kirsty Cleverly1

  • 1Fetal Medicine Centre, Barts Health NHS Trust, Royal London Hospital, Whitechapel, London E1 1BB, UK.

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|October 12, 2014
PubMed

Insights

Abnormal first-trimester maternal blood biomarkers, including PAPP-A and PP13, are linked to an increased risk of preeclampsia. This association is particularly strong for early-onset preeclampsia, indicating potential for early detection.

Area of Science:

  • Reproductive Medicine
  • Maternal-Fetal Medicine
  • Biomarker Discovery

Background:

  • Preeclampsia is a significant cause of maternal and fetal morbidity and mortality.
  • Early identification of preeclampsia risk is crucial for timely intervention and improved outcomes.
  • First-trimester maternal blood biomarkers are being investigated for their predictive potential.

Purpose of the Study:

  • To evaluate the association between abnormal first-trimester maternal blood biomarker levels and the risk of developing preeclampsia.
  • To determine if specific biomarkers are more strongly associated with early-onset versus late-onset preeclampsia.

Main Methods:

  • A systematic literature search was conducted across MEDLINE, EMBASE, and Cochrane databases up to April 2013.
  • Included studies assessed the association between any abnormal first-trimester maternal blood biomarker and preeclampsia.
  • Data were extracted and quality assessed by two independent reviewers; results were pooled using odds ratios (OR) with 95% confidence intervals (CI).

Main Results:

  • Thirty studies (65,538 women) were included. Biomarkers PAPP-A (OR 2.1), PP13 (OR 4.4), sFlt-1 (OR 1.3), pentraxin (OR 5.3), and inhibin-A (OR 3.6) were associated with any preeclampsia.
  • For early-onset preeclampsia, elevated PlGF (OR 3.4), PAPP-A (OR 4.8), PP13 (OR 7.5), soluble endoglin (OR 18.5), and inhibin-A (OR 4.1) showed significant associations.
  • Soluble endoglin (OR 2.1) and inhibin-A (OR 1.9) were significantly associated with late-onset preeclampsia.

Conclusions:

  • Abnormal maternal blood biomarker levels in early pregnancy are significantly associated with an increased risk of preeclampsia.
  • The association is particularly pronounced for early-onset preeclampsia, highlighting the potential for first-trimester screening.
  • Specific biomarkers like soluble endoglin and inhibin-A may aid in predicting late-onset preeclampsia.
Abstract

Keywords:
BiomarkersFirst-trimesterPredictionPreeclampsiaPregnancy

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