ПРОГНОСТИЧЕСКИЕ ФАКТОРЫ РИСКА РАЗВИТИЯ ПРЕЭКЛАМПСИИ: СОВРЕМЕННЫЙ ВЗГЛЯД НА ПРОБЛЕМУ. СИСТЕМАТИЧЕСКИЙ ОБЗОР

Abstract

Significance Preeclampsia is one of the common complications that significantly affects both pregnancy progress and delivery and the newborn health and can be also frequently followed by the death of mother and baby. This substantiates the need to identify risk factors for predicting preeclampsia The purpose of the study was to identify prognostic risk factors of preeclampsia. Material and methods. This systematic review analyzed modern studies on risk factors of preeclampsia and clinical, laboratory and instrumental methods of analysis to identify risk factors of preeclampsia as well as approaches to their assessment. The systematic review was conducted according to the PRISMA guidelines using certain PICO(S) criteria. Results The risk of preeclampsia should be assessed by risk factors to predict preeclampsia early in gestation. To identify such factors in various studies of Russian and foreign authors, the authors analyzed anamnestic factors and results of laboratory and instrumental diagnostic methods. Thus, a history of elevated blood pressure indicates an increased risk of preeclampsia. The highest risk of preeclampsia is registered in pregnant women with antiphospholipid syndrome. Most risk factors of preeclampsia are not potentially avoidable, except for excessive weight gain during pregnancy and multiple pregnancies, such as IVF. According to some researchers, the determination of laboratory parameters (platelet count, creatinine level, liver enzymes and urine protein) can help to predict preeclampsia. Changes in the absolute levels of angiogenic proteins of ischemic trophoblast VEGF, PlGF, sFlt-1, and sEng in mother’s blood and urine not only precede the onset of preeclampsia by several weeks or months, but also correlate with the disease severity and normalize after the delivery, suggesting a high prognostic value of this risk factor. Meta-analyses show that Doppler assessment of blood flow in uterine arteries can predict the risk of preeclampsia. Conclusion. As prognostic risk factors for preventive measures, with a high degree of probability the following set of data should be evaluated: arterial hypertension, antiphospholipid syndrome, obesity, multiple pregnancy, the history of assisted reproductive technologies, assessment results of blood flow in the uterine arteries, some laboratory blood parameters. The search for new predictive risk factors of preeclampsia requires further research.