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:
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-
(Preview, Version of record, pdf, 291.8KB, Terms of use)
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- Publisher copy:
- 10.1111/1471-0528.18194
Authors
Contributors
+ Papageorghiou, A
- Institution:
- University of Oxford
- Division:
- MSD
- Department:
- Women's & Reproductive Health
- Role:
- Contributor
+ Noble, J
- Institution:
- University of Oxford
- Division:
- MPLS
- Department:
- Engineering Science
- Role:
- Contributor
- ORCID:
- 0000-0002-3060-3772
+ Craik, R
- Institution:
- University of Oxford
- Division:
- MSD
- Department:
- Women's & Reproductive Health
- Role:
- Contributor
+ UK Research and Innovation
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:
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1471-0528
- ISSN:
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1470-0328
- Pmid:
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40344291
- Language:
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English
- Keywords:
- Subtype:
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Review
- Pubs id:
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2124079
- Local pid:
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pubs:2124079
- Deposit date:
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2025-06-30
- ARK identifier:
Terms of use
- Copyright holder:
- Elawad et al
- Copyright date:
- 2025
- Rights statement:
- © 2025 The Author(s). BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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