Toure Drissa M, ElRayes Wael, Barnes-Josiah Debora, Hartman Teresa, Klinkebiel David, Baccaglini Lorena
a Department of Health Promotion, Social and Behavioral Health , College of Public Health, University of Nebraska Medical Center , Omaha , NE , USA.
b Department of Environmental, Agricultural and Occupational Health , College of Public Health, University of Nebraska Medical Center , Omaha , NE , USA.
J Matern Fetal Neonatal Med. 2018 Feb;31(4):530-541. doi: 10.1080/14767058.2017.1291620. Epub 2017 Feb 28.
Preterm birth (PTB) is one of the leading causes of neonatal mortality and morbidity around the world. Epigenetic alterations of the human placenta may be involved in the causal chain of adverse pregnancy outcomes specifically PTB. In this systematic review, we investigated whether epigenetic dysregulation of the human placenta is associated with PTB.
We searched MEDLINE and EMBASE and systematically reviewed all relevant studies on epigenetic placental modifications in PTB. Two independent reviewers selected controlled human studies published in any language, evaluated their quality, and graded them using the Newcastle-Ottawa Quality Assessment Scale. We resolved disagreements by consensus with a third reviewer.
Eleven observational studies of low to moderate quality met the eligibility criteria out of 60 unique studies. Most studies reported an association between placental epigenetic changes (methylation, mRNA and miRNA) and PTB, although research methods were highly heterogeneous.
Studies reported various associations between specific epigenetic findings and PTB, although methodological concerns limited results' validity. Additional high quality studies are needed to assess the repeatability of these findings. The STROBE guidelines can be used to improve the quality of reporting.
早产是全球新生儿死亡和发病的主要原因之一。人类胎盘的表观遗传改变可能参与了不良妊娠结局（尤其是早产）的因果链。在本系统评价中，我们调查了人类胎盘的表观遗传失调是否与早产相关。
我们检索了MEDLINE和EMBASE，并系统评价了所有关于早产中胎盘表观遗传修饰的相关研究。两名独立的评审员选择以任何语言发表的对照人体研究，评估其质量，并使用纽卡斯尔-渥太华质量评估量表对其进行分级。我们通过与第三位评审员达成共识来解决分歧。
在60项独特的研究中，有11项质量低至中等的观察性研究符合纳入标准。尽管研究方法高度异质，但大多数研究报告了胎盘表观遗传变化（甲基化、mRNA和miRNA）与早产之间的关联。
研究报告了特定表观遗传结果与早产之间的各种关联，尽管方法学问题限制了结果的有效性。需要更多高质量的研究来评估这些发现的可重复性。STROBE指南可用于提高报告质量。
