Journal article icon

Journal article : Review

Towards the development of a conceptual framework of the determinants of pre-eclampsia: a hierarchical systematic review of biomarkers

Abstract:
Background
Pre-eclampsia is a leading cause of maternal and perinatal morbidity and mortality. There are several determinants of individual pregnant women's risk of developing pre-eclampsia, including biomarkers and ultrasound markers.
Objective
A conceptual framework to collate and summarise the extensive body of literature on biomarkers (including ultrasound markers) associated with pre-eclampsia, through a hierarchical systematic literature review.
Search Strategy
Medline, Embase, Health Technology Assessments, Database of Abstracts of Reviews of Effects, Cochrane Library were searched until April 2024.
Selection Criteria
Reviews and cohort studies (> 100 participants) reporting biomarkers associated with pre-eclampsia were included.
Data Collection and Analysis
Studies were screened by title, then abstract and full text. Evidence was prioritised from umbrella reviews, followed by systematic reviews and then observational studies. Associations were assessed for strength of association and quality of evidence using GRADE.
Main Results
The biomarker domain included 40 individual determinants of pre-eclampsia. Of these, there were 18 biomarkers with definite or probable associations based on moderate-strong quality evidence across markers of angiogenic imbalance, fetal-placental unit function, inflammatory and immune markers, and physiological markers. Vascular endothelial growth factor, human chorionic gonadotropin, inhibin-A, maternal serum placental protein-13, and interferon-gamma had definite associations based on high-quality evidence.
Conclusion
Biomarkers associated with the development of pre-eclampsia highlight the multi-factorial aetiology of the syndrome. The addition of biomarkers, including ultrasound, will optimise the prediction of pre-eclampsia and enable individualised risk stratification.
Publication status:
Published
Peer review status:
Peer reviewed

Actions

Access Document

Files:
Publisher copy:
10.1111/1471-0528.18194

Authors

More by this author
Role:
Author
ORCID:
0000-0001-5846-3014

Contributors

Institution:
University of Oxford
Division:
MSD
Department:
Women's & Reproductive Health
Role:
Contributor
Institution:
University of Oxford
Division:
MPLS
Department:
Engineering Science
Role:
Contributor
ORCID:
0000-0002-3060-3772
Institution:
University of Oxford
Division:
MSD
Department:
Women's & Reproductive Health
Role:
Contributor


More from this funder
Funder identifier:
https://ror.org/001aqnf71
Grant:
MR/P027938/1


Publisher:
Wiley
Journal:
BJOG: An International Journal of Obstetrics and Gynaecology More from this journal
Place of publication:
England
Publication date:
2025-05-08
Acceptance date:
2025-04-08
DOI:
EISSN:
1471-0528
ISSN:
1470-0328
Pmid:
40344291


Language:
English
Keywords:
Subtype:
Review
Pubs id:
2124079
Local pid:
pubs:2124079
Deposit date:
2025-06-30
ARK identifier:

Terms of use


Views and Downloads






If you are the owner of this record, you can report an update to it here: Report update to this record

TO TOP