Keshari Jiut Ram, Prakash Pritam, Sinha Seema Rani, Prakash Prem, Rani Kirti, Aziz Tarique, Shilpa Shaily
Department of Biochemistry, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.
Department of General Surgery, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.
Int J Reprod Biomed. 2025 May 1;23(2):111-130. doi: 10.18502/ijrm.v23i2.18476. eCollection 2024 May.
Recent studies reveal an association between increased cell-free fetal (cff) nucleic acid in maternal blood and pregnancy challenges like loss, pre-eclampsia, growth restriction, and preterm labor.
This article assesses the role of cff nucleic acids as potential diagnostic markers for the prediction and monitoring progression of severe pregnancy-related complications.
In this systematic review and meta-analysis, various databases were searched. Original articles reporting on the role of cff nucleic acids in predicting the complications of pregnancy were included. I square test and funnel plot were used to analyze heterogeneity and publication bias, respectively. The quality of studies was assessed using the critical appraisal checklists for studies created by the Joanna Briggs Institute.
70 publications were selected for the final qualitative analysis. Articles were published between 2010 and 2023, and most studies were conducted in the USA and China. The majority of studies were conducted on the quantity of cff-DNA (n = 40), and the remaining on microRNA (n = 18), messenger RNA (n = 11), and cell-free RNA (n = 1). The pooled sensitivity of cff nucleic acids for detecting trisomy was found to be 90.9 (95% CI: 80.9-100%). MicroRNA levels were significantly increased in participants with gestational diabetes mellitus, with a standardized mean difference of 1.22 (95% CI: -0.90-3.34).
Fetal nucleic acids can serve as accurate noninvasive diagnostic tools for predicting serious complications during pregnancy.
近期研究揭示，母血中游离胎儿（cff）核酸水平升高与诸如流产、子痫前期、生长受限和早产等妊娠挑战之间存在关联。
本文评估cff核酸作为预测和监测严重妊娠相关并发症进展的潜在诊断标志物的作用。
在本系统评价和荟萃分析中，检索了各种数据库。纳入了报道cff核酸在预测妊娠并发症中作用的原始文章。分别使用I²检验和漏斗图分析异质性和发表偏倚。使用乔安娜·布里格斯研究所制定的研究批判性评价清单评估研究质量。
70篇出版物被选入最终的定性分析。文章发表于2010年至2023年之间，大多数研究在美国和中国进行。大多数研究针对cff-DNA的数量（n = 40），其余研究针对微小RNA（n = 18）、信使RNA（n = 11）和游离RNA（n = 1）。发现cff核酸检测三体的合并敏感性为90.9（95%CI：80.9 - 100%）。妊娠糖尿病患者的微小RNA水平显著升高，标准化平均差为1.22（95%CI： - 0.90 - 3.34）。
胎儿核酸可作为预测妊娠期间严重并发症的准确非侵入性诊断工具。
