Kosinska-Kaczynska Katarzyna, Malicka Ewa, Szymusik Iwona, Dera Norbert, Pruc Michal, Feduniw Stepan, Rafique Zubaid, Szarpak Lukasz
Department of Obstetrics, Perinatology and Neonatology, Center of Postgraduate Medical Education, 01-813 Warsaw, Poland.
Research Unit, Polish Society of Disaster Medicine, 05-816 Warsaw, Poland.
J Clin Med. 2023 Jan 29;12(3):1059. doi: 10.3390/jcm12031059.
COVID-19 in pregnant women increases the risk of adverse pregnancy outcomes, including preeclampsia. This meta-analysis aimed to examine the effect of SARS-CoV-2 infection on sFlt-1/PIGF ratio during pregnancy. The study was designed as a systematic review and meta-analysis. PubMed, Web of Science, Embase and Cochrane Library were searched for relevant studies reporting the sFlt-1/PlGF ratio in pregnant women with COVID-19. Results were compared using meta-analysis by the Mantel-Haenszel method. A total of 7 studies were included in the analysis. sFlt-1/PlGF ratios between COVID-19 positive vs. negative women were 45.8 ± 50.3 vs. 37.4 ± 22.5, respectively (SMD = 1.76; 95% CI: 0.43 to 3.09; = 0.01). sFlt-1/PlGF ratios between asymptomatic vs. symptomatic patients were 49.3 ± 35.7 vs. 37.1 ± 25.6 (SMD = 0.30; 95% CI: -0.35 to 0.95; = 0.36). sFlt-1/PlGF ratio in non-severe group was 30.7 ± 56.5, compared to 64.7 ± 53.5 for severe patients (SMD = -1.88; 95% CI: -3.77 to 0.01; = 0.05). sFlt-1/PlGF ratios in COVID-19 patients, with and without hypertensive disease of pregnancy, were 187.0 ± 121.8 vs. 21.6 ± 8.6, respectively (SMD = 2.46; 95% CI: 0.99 to 3.93; = 0.001). Conclusions: Patients with COVID-19, as compared to patients without COVID-19, were characterized by higher sFlt-1/PlGF ratio. Moreover, severe COVID-19 and SARS-CoV-2 infection in hypertensive pregnant women was related to significantly higher sFlt-1/PlGF ratio.
孕妇感染新冠病毒会增加不良妊娠结局的风险，包括子痫前期。这项荟萃分析旨在研究严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染对孕期可溶性血管内皮生长因子受体-1（sFlt-1）/胎盘生长因子（PIGF）比值的影响。该研究被设计为一项系统评价和荟萃分析。通过检索PubMed、科学网、Embase和考克兰图书馆，查找报告新冠病毒感染孕妇sFlt-1/胎盘生长因子（PlGF）比值的相关研究。采用Mantel-Haenszel方法进行荟萃分析以比较结果。分析共纳入7项研究。新冠病毒检测呈阳性与阴性的女性之间，sFlt-1/PlGF比值分别为45.8±50.3和37.4±22.5（标准化均数差[SMD]=1.76；95%置信区间[CI]：0.43至3.09；P=0.01）。无症状与有症状患者之间，sFlt-1/PlGF比值分别为49.3±35.7和37.1±25.6（SMD=0.30；95%CI：-0.35至0.95；P=0.36）。非重症组的sFlt-1/PlGF比值为30.7±56.5，而重症患者为64.7±53.5（SMD=-1.88；95%CI：-3.77至0.01；P=0.05）。患有和未患有妊娠高血压疾病的新冠病毒感染患者的sFlt-1/PlGF比值分别为187.0±121.8和21.6±8.6（SMD=2.46；95%CI：0.99至3.93；P=0.001）。结论：与未感染新冠病毒的患者相比，感染新冠病毒的患者sFlt-1/PlGF比值更高。此外，重症新冠病毒感染以及高血压孕妇感染SARS-CoV-2与显著更高的sFlt-1/PlGF比值有关。
