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MicroRNA-210 level as a biomarker for pre-eclampsia severity: A systematic review and meta-analysis
Dávid Márai1,2, Isabel Pinto Amorim das Virgens1, Ádám Vincze1,2
1Center for Translational Medicine, Semmelweis University, Budapest, Hungary.
Background:
Pre-eclampsia is a serious pregnancy-related syndrome lacking accurate prognostic markers. MicroRNA-210, overexpressed in the circulation of women with pre-eclampsia, has recently emerged as a promising biomarker.
Objectives:
We conducted a systematic review and meta-analysis to evaluate the relationship between miR-210 levels and pre-eclampsia at different degrees of severity.
Search Strategy:
The study was prospectively registered on PROSPERO (CRD42024604698) and included a comprehensive systematic search of five databases conducted on November 21, 2024.
Selection Criteria, Data Collection And Analysis:
The included studies involved pregnant women with mild or severe pre-eclampsia compared to normotensive controls, meeting guideline-based diagnostic criteria and reporting circulating microRNA-210. Precalculated effect sizes were pooled to obtain a weighted mean and 95% confidence interval (CI) for microRNA-210-fold increase. Subgroup analysis assessed pre-eclampsia severity, using an inverse variance method in random-effects meta-analysis models.
Main Results:
Our search identified 776 records, of which seven were deemed eligible for analysis. The fold change values, reflecting the increase in microRNA-210 levels between the control and pre-eclamptic populations, were 3.33 (CI: 0.69-5.98; I2 = 93%, CI: 88-96%) in the mild pre-eclampsia group and 7.23 (CI: 2.27-12.18; I2 = 98%, CI: 98-99%) in the severe pre-eclampsia group, indicating a significant effect (P = 0.01) in the subgroup difference tests. The mean ratio of microRNA-210-fold change between the two severity groups was 2.05 (CI: 1.41-2.69; I2 = 85%, P < 0.01), favoring the severe population.
Conclusion:
Elevated microRNA-210 levels are strongly associated with pre-eclampsia severity at the time of diagnosis, with a consistent, significant stepwise increase from mild to severe disease. Whether miR-210 holds predictive value earlier in pregnancy remains to be established in prospective studies with first-trimester sampling.
