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The diagnostic role of miRNAs in identifying placenta Accreta: a systematic review
Mohammad Haddadi1, Roxana Safari1, Sedigheh Hantoushzadeh1
1Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University Of Medical Sciences, Tehran, Iran.
Objective:
This systematic review evaluates the diagnostic accuracy of circulating microRNAs (miRNAs) as potential biomarkers for detecting placenta accreta spectrum (PAS) disorders, a condition characterized by abnormal placental adherence with significant maternal health risks.
Data Sources:
A comprehensive literature search was conducted in PubMed, Embase, and Scopus databases up to October 30, 2024, using predefined keywords such as "miRNA" and "placenta accreta."
Study Eligibility:
Studies investigating miRNA expression in PAS cases compared to controls, using either blood or placental tissue, were included. Articles were screened independently by 2 reviewers, with discrepancies resolved by consensus.
Study Appraisal And Synthesis Methods:
The methodological quality of eligible studies was assessed using the Newcastle-Ottawa Scale. Extracted data were synthesized to identify miRNAs with diagnostic potential for PAS disorders. Due to significant variations in the comparisons conducted across studies and the diverse outcome measures reported, a meta-analysis of the included studies was not feasible.
Results:
Out of 82 articles identified, 14 met the inclusion criteria after duplicate removal and screening. The studies reported distinct differential expression patterns of miRNAs in PAS cases. Notably, a combination of miR-26a-5p and miR-17-5p demonstrated 100% sensitivity and 82% specificity for predicting PAS in the first-trimester of pregnancy.
Conclusions:
PAS disorders are typically diagnosed during the third trimester through imaging techniques like ultrasonography. However, miRNAs exhibit promise as non-invasive, early biomarkers, potentially enabling earlier diagnosis and improved clinical management. These findings support the incorporation of miRNA analysis into diagnostic guidelines for PAS.
Insights
MicroRNAs (miRNAs) show promise as early, non-invasive biomarkers for placenta accreta spectrum (PAS) disorders. A combination of miR-26a-5p and miR-17-5p achieved high accuracy in first-trimester prediction.
Area of Science:
- Biochemistry
- Genetics
- Obstetrics
Background:
- Placenta accreta spectrum (PAS) disorders involve abnormal placental adherence, posing significant maternal health risks.
- Current diagnostic methods, primarily third-trimester imaging, often lead to delayed detection.
- There is a critical need for early and non-invasive diagnostic biomarkers for PAS.
Purpose of the Study:
- To systematically review the diagnostic accuracy of circulating microRNAs (miRNAs) for detecting placenta accreta spectrum (PAS) disorders.
- To identify specific miRNAs with potential as early biomarkers for PAS.
- To evaluate the feasibility of incorporating miRNA analysis into future PAS diagnostic guidelines.
Main Methods:
- A comprehensive literature search was performed in PubMed, Embase, and Scopus databases up to October 30, 2024.
- Studies examining miRNA expression in PAS cases versus controls (blood or placental tissue) were included and screened by two independent reviewers.
- Methodological quality was assessed using the Newcastle-Ottawa Scale; data were synthesized due to heterogeneity precluding meta-analysis.
Main Results:
- Fourteen studies met the inclusion criteria from 82 initially identified articles.
- Distinct differential expression patterns of miRNAs were observed in PAS cases.
- A combination of miR-26a-5p and miR-17-5p demonstrated 100% sensitivity and 82% specificity for first-trimester PAS prediction.
Conclusions:
- Circulating miRNAs hold significant promise as non-invasive, early diagnostic biomarkers for PAS disorders.
- Early detection through miRNA analysis could lead to improved clinical management and better maternal outcomes.
- These findings support the potential integration of miRNA detection into PAS diagnostic protocols.
