Abstract
ObjectiveThe aim of the present study was to investigate the predictive value of using the multiple of the median (MoM) of β-human chorionic gonadotropin (β-hCG) levels in patients with preeclampsia (PE) and healthy pregnant women.MethodsElectronic databases including PubMed, EBSCO, Ovid, Web of Science, China National Knowledge Infrastructure (CNKI), SinoMed, Wangfang and the Weipu Journal were searched up to May 31, 2020. Two reviewers independently selected the articles and extracted data on study characteristics, quality and results. A random-effects model was employed, and standardized mean difference and 95% confidence intervals were calculated. Twenty-one case-control studies were analyzed in the present meta-analysis, including a total of 2,266 cases and 25,872 healthy controls.ResultsWomen who were diagnosed with PE were found to have higher early second-trimester levels of serum β-hCG MoM compared with healthy controls, although the levels in the first trimester were not significantly different. Ethnicity subgroup analysis demonstrated that the MoM of β-hCG serum levels was significantly higher in PE patients in both Asian and Caucasian populations during the early second trimester.ConclusionThe MoM of β-hCG serum levels was found to be a valuable clinical indicator for predicting PE in the early second trimester, but had little predictive value in the first trimester. However, further assessment of the predictive capacity of β-hCG within larger, diverse populations is required.
Highlights
Preeclampsia (PE) is an idiopathic disease of pregnancy that may lead to multi-organ damage, and it is a multi-systemic disorder that is associated with poor early placentation and is characterized by new-onset hypertension and proteinuria after 20 weeks of gestation, with a significant impact on several organ systems, including renal and hepatic insufficiency, neurological complications, hematological complications, or evidence of uteroplacental dysfunction [1,2,3,4]
Some studies indicated that b-human chorionic gonadotropin (b-hCG) is involved in PE, and b-hCG has been recommended as a serum maker for screening PE at 8-14 weeks of gestation [8, 9]
124 studies were removed following a more detailed full-text assessment, including 47 studies that were not cohort or case-control studies, 19 studies that were unrelated to PE and 58 that were unrelated to b-hCG MoM
Summary
Preeclampsia (PE) is an idiopathic disease of pregnancy that may lead to multi-organ damage, and it is a multi-systemic disorder that is associated with poor early placentation and is characterized by new-onset hypertension and proteinuria after 20 weeks of gestation, with a significant impact on several organ systems, including renal and hepatic insufficiency, neurological complications, hematological complications, or evidence of uteroplacental dysfunction [1,2,3,4]. PE is the second leading cause of maternal mortality on a global scale, and it is the main cause of pregnancy-related. The factors affecting PE remain unclear, most studies suggest that the main pathogenic mechanism maybe inadequate trophoblast invasion into maternal spiral arteries, resulting in decreased placental blood flow, trophoblast apoptosis and proinflammatory cytokine production [7]. Some studies indicated that b-human chorionic gonadotropin (b-hCG) is involved in PE, and b-hCG has been recommended as a serum maker for screening PE at 8-14 weeks of gestation [8, 9]
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