Alemayehu Ermiyas, Gedefie Alemu, Getu Fasil, Mulatie Zewudu, Walle Muluken, Mohammed Ousman, Bambo Getachew Mesfin, Debash Habtu, Solomon Yenealem, Mohammed Abdurehman Eshete, Ebrahim Hussen, Belete Melaku Ashagrie
Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia.
BMC Pregnancy Childbirth. 2025 Aug 6;25(1):822. doi: 10.1186/s12884-025-07964-8.
Preeclampsia (PE) is a significant obstetric and global health concern associated with fetal growth restriction, poor placental perfusion, and maternal organ dysfunction. Early detection through simple, routine antenatal indicators is essential. This systematic review and meta-analysis assessed fibrinogen (FIB) and D-dimer (DD) levels in PE patients compared to normotensive pregnant women.
Relevant articles were systematically identified through comprehensive searches across multiple databases such as PubMed, Scopus, Embase, and Hinari. Utilizing Stata version 14.0, we employed a random-effects model to estimate the pooled standardized mean difference (SMD) along with their corresponding 95% confidence intervals (CIs). Heterogeneity was assessed using I statistics and the Cochrane Q test, while subgroup analyses and meta-regression were conducted to investigate potential sources of heterogeneity. Additionally, sensitivity analysis was performed to assess the robustness of the findings. Furthermore, Egger's regression test and funnel plot were utilized to evaluate publication bias among the included studies.
In total, 31 articles involving 5,846 participants were included in this study. Among these, 2,938 were identified as patients with PE (664 severe PE, 619 mild PE, and 1,655 undefined PE), while 2,908 were normotensive pregnant mothers. The overall pooled standardized mean difference (SMD) for FIB and DD between PE and normotensive pregnant mothers were 0.26 (95% CI: -0.12-0.64, p = 0.18) and 0.81 (95% CI: 0.43-1.18, p < 0.001), respectively. These findings suggest a significant increase in DD levels among PE patients compared to normotensive pregnant mothers, while the elevation in FIB levels among PE patients did not reach statistical significance.
These findings highlight the potential utility of DD as a biomarker for identifying and monitoring PE during pregnancy. However, further research is warranted to elucidate the clinical implications and predictive value of DD levels in the context of PE diagnosis and management. Additionally, the non-significant difference in FIB levels highlights the need for continued investigation into the underlying mechanisms and diagnostic relevance of FIB in PE.
子痫前期（PE）是一个重大的产科和全球健康问题，与胎儿生长受限、胎盘灌注不良及母体器官功能障碍相关。通过简单的常规产前指标进行早期检测至关重要。本系统评价和荟萃分析评估了与血压正常的孕妇相比，PE患者的纤维蛋白原（FIB）和D-二聚体（DD）水平。
通过在多个数据库（如PubMed、Scopus、Embase和Hinari）中进行全面检索，系统地识别相关文章。利用Stata 14.0版本，我们采用随机效应模型来估计合并的标准化均值差（SMD）及其相应的95%置信区间（CIs）。使用I统计量和Cochrane Q检验评估异质性，同时进行亚组分析和荟萃回归以调查异质性的潜在来源。此外，进行敏感性分析以评估研究结果的稳健性。此外，利用Egger回归检验和漏斗图评估纳入研究中的发表偏倚。
本研究共纳入31篇文章，涉及5846名参与者。其中，2938名被确定为PE患者（664名重度PE、619名轻度PE和1655名未明确PE），而2908名是血压正常的孕妇。PE患者与血压正常的孕妇之间FIB和DD的总体合并标准化均值差分别为0.26（95%CI：-0.12 - 0.64，p = 0.18）和0.81（95%CI：0.43 - 1.18，p < 0.001）。这些结果表明，与血压正常的孕妇相比，PE患者的DD水平显著升高，而PE患者的FIB水平升高未达到统计学意义。
这些发现突出了DD作为孕期识别和监测PE的生物标志物的潜在效用。然而，有必要进一步研究以阐明DD水平在PE诊断和管理背景下的临床意义和预测价值。此外，FIB水平无显著差异凸显了继续研究FIB在PE中的潜在机制和诊断相关性的必要性。
