Abdeldaem Mohamed Rumaissa Haidar, Ahmed Ali Alfaki Nahla Mohamed, Belal Rania E, Ali Dawelbait Azza Mohamed, Hamad Yousif Reem Badawi, Mohamed Shahinaz A E, Badre Adam Hind Suliman, Abbashar Abdelmahmoud Eman Mohammed
Obstetrics and Gynaecology, Abu Arish General Hospital, Jazan, SAU.
Obstetrics and Gynaecology, Mouwasat Hospital, Jubail, SAU.
Cureus. 2025 Jul 11;17(7):e87734. doi: 10.7759/cureus.87734. eCollection 2025 Jul.
Preeclampsia (PE) remains a leading cause of maternal and perinatal morbidity and mortality, with systemic inflammation playing a central role in its pathogenesis. Despite extensive research on inflammatory biomarkers, inconsistencies persist regarding their associations with disease severity and onset. This systematic review synthesizes current evidence on the relationship between inflammatory biomarkers and PE, focusing on their diagnostic and prognostic potential. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, a comprehensive search was conducted across five databases (PubMed, Scopus, Web of Science, Embase, and CINAHL) to identify observational studies investigating inflammatory biomarkers in PE. Eligible studies included case-control, cross-sectional, and cohort designs with normotensive controls. Data extraction covered study characteristics, biomarker profiles, and clinical outcomes. Methodological quality was assessed using the Newcastle-Ottawa Scale. In total, 13 studies were included, predominantly from diverse geographical regions. Pro-inflammatory cytokines and acute-phase proteins (C-reactive protein) were consistently elevated in PE, with distinct profiles for early-onset (placental-driven inflammation) and late-onset (systemic inflammation) subtypes. Biomarkers such as neopterin and soluble urokinase-type plasminogen activator receptor showed promise in stratifying disease severity. Maternal-fetal inflammatory cascades were evident, with correlations between maternal biomarkers and adverse neonatal outcomes. However, heterogeneity in study designs, biomarker measurement timing, and inconsistent adjustments for confounders limited comparability. Quality assessment revealed seven low-risk and six moderate-risk studies, with no high-risk bias. Inflammatory biomarkers demonstrate significant associations with PE severity and onset, supporting their role in disease monitoring and risk stratification. However, methodological inconsistencies highlight the need for standardized protocols and larger, longitudinal studies to validate their clinical utility. Future research should integrate multi-omics approaches to refine biomarker panels and elucidate causal pathways, ultimately guiding targeted interventions.
子痫前期（PE）仍然是孕产妇和围产儿发病和死亡的主要原因，全身炎症在其发病机制中起核心作用。尽管对炎症生物标志物进行了广泛研究，但它们与疾病严重程度和发病之间的关联仍存在不一致。本系统评价综合了关于炎症生物标志物与PE之间关系的现有证据，重点关注其诊断和预后潜力。按照《系统评价和Meta分析的首选报告项目（PRISMA）2020》指南，对五个数据库（PubMed、Scopus、Web of Science、Embase和CINAHL）进行了全面检索，以识别调查PE中炎症生物标志物的观察性研究。符合条件的研究包括病例对照、横断面和队列设计，并以血压正常者作为对照。数据提取涵盖研究特征、生物标志物概况和临床结局。使用纽卡斯尔-渥太华量表评估方法学质量。总共纳入了13项研究，主要来自不同地理区域。促炎细胞因子和急性期蛋白（C反应蛋白）在PE中持续升高，早发型（胎盘驱动炎症）和晚发型（全身炎症）亚型有不同的特征。新蝶呤和可溶性尿激酶型纤溶酶原激活剂受体等生物标志物在分层疾病严重程度方面显示出前景。母胎炎症级联反应明显，母体生物标志物与不良新生儿结局之间存在相关性。然而，研究设计、生物标志物测量时间的异质性以及对混杂因素的不一致调整限制了可比性。质量评估显示有7项低风险和6项中度风险研究，无高风险偏倚。炎症生物标志物与PE严重程度和发病存在显著关联，支持它们在疾病监测和风险分层中的作用。然而，方法学上的不一致突出表明需要标准化方案以及更大规模的纵向研究来验证其临床效用。未来的研究应整合多组学方法来完善生物标志物组合并阐明因果途径，最终指导靶向干预。
