Wu Yifan, Liu Yang, Ding Yiling
Department of Obstetrics, The Second Xiangya Hospital, Central South University, Changsha, China.
Department of Obstetrics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Front Med (Lausanne). 2021 Nov 19;8:756383. doi: 10.3389/fmed.2021.756383. eCollection 2021.
Preeclampsia is a pregnancy-specific syndrome that affects maternal and neonatal mortality. Several serum biomarkers can be used to predict preeclampsia. Among these proteins, placental protein 13 (PP13) has received progressively more interest in recent studies. The decrease in PP13 expression is one of the earliest signs for the development of preeclampsia and has shown its predictive performance for preeclampsia. In this meta-analysis, we collected 17 observational studies with 40,474 pregnant women. The overall sensitivity of PP13 to predict preeclampsia was 0.62 [95% confidence interval (CI) = 0.49-0.74], the specificity was 0.84 (95%CI = 0.81-0.86), and the diagnostic odds ratio was nine (95%CI = 5-15). The area under the curve for summary receiver operating characteristic was 0.84. We then chose the early-onset preeclampsia as a subgroup. The sensitivity of early-onset subgroup was 0.63 (95%CI = 0.58-0.76), the specificity was 0.85 (95%CI = 0.82-0.88), and the diagnostic odds ratio was 10 (95%CI = 6-18). The findings of our meta-analysis indicate that PP13 may be an effective serum biomarker for the predictive screening of preeclampsia. Nonetheless, large prospective cohort studies and randomized controlled trials are expected to uncover its application in clinical practice. The heterogeneity of the original trials may limit the clinical application of PP13. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=188948 The meta-analysis was registered in PROSPERO (CRD42020188948).
子痫前期是一种特定于妊娠的综合征，会影响孕产妇和新生儿死亡率。几种血清生物标志物可用于预测子痫前期。在这些蛋白质中，胎盘蛋白13（PP13）在最近的研究中越来越受到关注。PP13表达的降低是子痫前期发展的最早迹象之一，并已显示出其对子痫前期的预测性能。在这项荟萃分析中，我们收集了17项观察性研究，涉及40474名孕妇。PP13预测子痫前期的总体敏感性为0.62[95%置信区间（CI）=0.49-0.74]，特异性为0.84（95%CI=0.81-0.86），诊断比值比为9（95%CI=5-15）。汇总受试者工作特征曲线下面积为0.84。然后，我们将早发型子痫前期作为一个亚组。早发型亚组的敏感性为0.63（95%CI=0.58-0.76），特异性为0.85（95%CI=0.82-0.88），诊断比值比为10（95%CI=6-18）。我们的荟萃分析结果表明，PP13可能是一种有效的血清生物标志物，用于子痫前期的预测性筛查。尽管如此，大型前瞻性队列研究和随机对照试验有望揭示其在临床实践中的应用。原始试验的异质性可能会限制PP13的临床应用。https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=188948该荟萃分析已在PROSPERO（CRD42020188948）中注册。
