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Veisani, Y., Jenabi, E., Delpisheh, A., & Khazaei, S. (2019). Angiogenic factors and the risk of preeclampsia: A systematic review and meta-analysis. International Journal of Reproductive BioMedicine (IJRM), 17(1), 1-10. https://doi.org/10.18502/ijrm.v17i1.3815
https://doi.org/10.18502/ijrm.v17i1.3815
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- Cited by 8 articles
authors
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Yousef Veisani
No author data available.
-
Ensiyeh Jenabi
No author data available.
-
Ali Delpisheh
No author data available.
-
Salman Khazaei
No author data available.
Published Date
- Mar 7, 2019
Angiogenic factors and the risk of preeclampsia: A systematic review and meta-analysis
Abstract
Background: The etiological nature of preeclampsia is heterogeneous. The use of biomarkers indices in early pregnancy helps to have appropriate stratification of pregnancies into high- and low risk for the purpose of choosing timely interventions.
Objective: The aim of this systematic review was to determine the pathogenic role of soluble soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) inthe prediction of preeclampsia in women.
Materials and Methods: We performed a systematic search of the international databases including PubMed, Scopus, and Web of Science until August 2017. The quality of included studies was assessed using the Newcastle-Ottawa Scale. The primary outcome in this review was preeclampsia. The statistical heterogeneity was assessed using the X2 test and quantified by I2. Pooled effects size was obtained by random effects model. Subgroup analyses were also carried out.
Results: Totally, 284 records were identified in the initial search and 15 records were finally included in the meta-analysis. The pooled odds ratios (ORs) for the association between the high level of sFlt-1 and low level of PlGF and subsequent development of preeclampsia among women were 5.20 (95% CI: 1.24–9.16) and 2.53 (95% CI: 1.33–3.75), respectively. The mean difference for sFlt-1 and PlGF in women with preeclampsia compared to controls was 1.15 (95% CI: 0.43–1.86) and –0.94 (95% CI: –1.37–0.52),respectively.
Conclusion: According to the results from this meta-analysis, increased levels of sFlt-1 and reduced levels of PlGF predict the subsequent development of preeclampsia.
Key words: Angiogenic factors, Preeclampsia, sFLT-1, PlGF.
References
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Hajifathalian K, Ezzati M, Woodward M, Rimm EB, et al. Metabolic mediators of the effects of body-mass index,
overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with
1·8 million participants. Lancet 2014; 383: 970–983.
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[3] Kim SY, Ryu HM, Yang JH, Kim MY, Han JY, Kim JO, et al. Increased sFlt-1 to PlGF ratio in women who subsequently develop preeclampsia. J Korean Med Sci 2007; 22: 873–877.
[4] Poorolajal J, Jenabi E. The association between body mass index and preeclampsia: a meta-analysis. J Matern
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[5] Powe CE, Levine RJ, Karumanchi SA. Preeclampsia, a disease of the maternal endothelium: the role of antiangiogenic factors and implications for later cardiovascular disease. Circulation 2011; 123: 2856–2869.
[6] Tarasevičienė V, Grybauskienė R, Mačiulevičienė R. sFlt1, PlGF, sFlt-1/PlGF ratio and uterine artery Doppler for
preeclampsia diagnostics. Medicina (Kaunas) 2016; 52:349–353.
[7] Verlohren S, Galindo A, Schlembach D, Zeisler H, Herraiz I, Moertl MG, et al. An automated method for the
determination of the sFlt-1/PIGF ratio in the assessment of preeclampsia. Am J Obstet Gynecol 2010; 202: 161. e1–161.e11.
[8] Peters JP, Hooft L, Grolman W, Stegeman I. Reporting quality of systematic reviews and meta-analyses of otorhinolaryngologic articles based on the PRISMA statement.PLoS One 2015; 10: e0136540–e0136550.
[9] Tranquilli AL, Dekker G, Magee L, Roberts J, Sibai BM, Steyn W, et al. The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP. Pregnancy Hypertens2014; 4: 97–104.
[10] Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS)
for assessing the quality of nonrandomised studies in meta-analyses. 2009 Available from: http://www.ohri.ca/
programs/clinical_epidemiology/oxford.asp.
[11] Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ1997; 315: 629–634.
[12] Levine RJ, Maynard SE, Qian C, Lim KH, England LJ, Yu KF, et al. Circulating angiogenic factors and the risk of
preeclampsia. N Engl J Med 2004; 350: 672–683.
[13] Polliotti BM, Fry AG, Saller DN, Mooney RA, Cox C, Miller RK. Second-trimester maternal serum placental growth factor and vascular endothelial growth factor for predicting severe, early-onset preeclampsia. Obstet Gynecol 2003;101: 1266–1274.
[14] Shibata E, Rajakumar A, Powers RW, Larkin RW, Gilmour C, Bodnar LM, et al. Soluble fms-Like Tyrosine Kinase 1 Is Increased in Preeclampsia But Not in Normotensive Pregnancies with Small-for-Gestational-Age Neonates: Relationship to Circulating Placental Growth Factor. J Clin Endocrinol Metab 2005; 90: 4895–4903.
[15] Tsatsaris V, Goffin F, Munaut C, Brichant JF, Pignon MR, Noel A, et al. Overexpression of the soluble vascular endothelial growth factor receptor in preeclamptic patients: pathophysiological consequences. J Clin Endocrinol Metab 2003; 88: 5555–5563.
[16] Woodham PC, Brittain JE, Baker AM, Long DL, Haeri S, Camargo CA, et al. Midgestation maternal serum
25-hydroxyvitamin D level and soluble fms-like tyrosine kinase 1/placental growth factor ratio as predictors of
severe preeclampsia. Hypertension 2011; 58: 1120–1125.
[17] Erez O, Romero R, Espinoza J, Fu W, Todem D, Kusanovic JP, et al. The change in concentrations of angiogenic
and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-forgestational age. J Matern Fetal Neonatal Med 2008; 21:279–287.
[18] Kusanovic JP, Romero R, Chaiworapongsa T, Erez O, Mittal P, Vaisbuch E, et al. A prospective cohort study of the value of maternal plasma concentrations of angiogenic and antiangiogenic factors in early pregnancy and midtrimester in the identification of patients destined to develop preeclampsia. J Maternal Fetal Neonatal Med 2009; 22:1021–1038.
[19] Thadhani R, Mutter WP, Wolf M, Levine RJ, Taylor RN, Sukhatme VP, et al. First trimester placental growth
factor and soluble fms-like tyrosine kinase 1 and risk for preeclampsia. J Clin Endocrinol Metab 2004; 89: 770–775.
[20] Lim JH, Kim SY, Park SY, Yang JH, Kim MY, Ryu HM. Effective prediction of preeclampsia by a combined ratio
of angiogenesis-related factors. Obstet Gynecol 2008; 111:1403–1409.
[21] Haggerty CL, Seifert ME, Tang G, Olsen J, Bass DC, Karumanchi SA, et al. Second trimester anti-angiogenic
proteins and preeclampsia. Pregnancy Hypertens 2012; 2:158–163.
[22] Crispi F, Llurba E, Domínguez C, Martín-Gallán P, Cabero L, Gratacós E. Predictive value of angiogenic factors and uterine artery Doppler for early- versus late-onset preeclampsia and intrauterine growth restriction. UltrasoundObstet Gynecol 2008; 31: 303–309.
[23] March MI, Geahchan C, Wenger J, Raghuraman N, Berg A, Haddow H, et al. Circulating angiogenic factors and the risk of adverse outcomes among haitian women with preeclampsia. PloS One 2015; 10: e0126815.
[24] De Vivo A, Baviera G, Giordano D, Todarello G, Corrado F, D’Anna R. Endoglin, PlGF and sFlt-1 as markers for
predicting pre-eclampsia. Acta Obstet Gynecol Scand 2008; 87: 837–842.
[25] Sunderji S, Gaziano E, Wothe D, Rogers LC, Sibai B, Karumanchi SA, et al. Automated assays for sVEGF R1 and
PlGF as an aid in the diagnosis of preterm preeclampsia: a prospective clinical study. Am J Obstet Gynecol 2010;
202: 40.e1–7.
[26] Maynard SE, Min JY, Merchan J, Lim KH, Li J, Mondal S, et al. Excess placental soluble fms-like tyrosine kinase 1(sFlt1) may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia. J Clin Invest 2003;111: 649–658.
[27] Koga K, Osuga Y, Yoshino O, Hirota Y, Ruimeng X, Hirata T, et al. Elevated serum soluble vascular endothelial
growth factor receptor 1 (sVEGFR-1) levels in women with preeclampsia. J Clin Endocrinol Metab 2003; 88: 2348–
2351.
[28] Taylor RN, Grimwood J, Taylor RS, McMaster MT, Fisher SJ, North RA. Longitudinal serum concentrations of placental growth factor: Evidence for abnormal placental angiogenesis in pathologic pregnancies. Am J Obstet Gynecol 188:177–182.
Hajifathalian K, Ezzati M, Woodward M, Rimm EB, et al. Metabolic mediators of the effects of body-mass index,
overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with
1·8 million participants. Lancet 2014; 383: 970–983.
[2] American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American college of obstetricians and gynecologists’ task force on hypertension in pregnancy. Obstet Gynecol 2013; 122: 1122–1131.
[3] Kim SY, Ryu HM, Yang JH, Kim MY, Han JY, Kim JO, et al. Increased sFlt-1 to PlGF ratio in women who subsequently develop preeclampsia. J Korean Med Sci 2007; 22: 873–877.
[4] Poorolajal J, Jenabi E. The association between body mass index and preeclampsia: a meta-analysis. J Matern
Fetal Neonatal Med 2016; 29: 3670–3676.
[5] Powe CE, Levine RJ, Karumanchi SA. Preeclampsia, a disease of the maternal endothelium: the role of antiangiogenic factors and implications for later cardiovascular disease. Circulation 2011; 123: 2856–2869.
[6] Tarasevičienė V, Grybauskienė R, Mačiulevičienė R. sFlt1, PlGF, sFlt-1/PlGF ratio and uterine artery Doppler for
preeclampsia diagnostics. Medicina (Kaunas) 2016; 52:349–353.
[7] Verlohren S, Galindo A, Schlembach D, Zeisler H, Herraiz I, Moertl MG, et al. An automated method for the
determination of the sFlt-1/PIGF ratio in the assessment of preeclampsia. Am J Obstet Gynecol 2010; 202: 161. e1–161.e11.
[8] Peters JP, Hooft L, Grolman W, Stegeman I. Reporting quality of systematic reviews and meta-analyses of otorhinolaryngologic articles based on the PRISMA statement.PLoS One 2015; 10: e0136540–e0136550.
[9] Tranquilli AL, Dekker G, Magee L, Roberts J, Sibai BM, Steyn W, et al. The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP. Pregnancy Hypertens2014; 4: 97–104.
[10] Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS)
for assessing the quality of nonrandomised studies in meta-analyses. 2009 Available from: http://www.ohri.ca/
programs/clinical_epidemiology/oxford.asp.
[11] Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ1997; 315: 629–634.
[12] Levine RJ, Maynard SE, Qian C, Lim KH, England LJ, Yu KF, et al. Circulating angiogenic factors and the risk of
preeclampsia. N Engl J Med 2004; 350: 672–683.
[13] Polliotti BM, Fry AG, Saller DN, Mooney RA, Cox C, Miller RK. Second-trimester maternal serum placental growth factor and vascular endothelial growth factor for predicting severe, early-onset preeclampsia. Obstet Gynecol 2003;101: 1266–1274.
[14] Shibata E, Rajakumar A, Powers RW, Larkin RW, Gilmour C, Bodnar LM, et al. Soluble fms-Like Tyrosine Kinase 1 Is Increased in Preeclampsia But Not in Normotensive Pregnancies with Small-for-Gestational-Age Neonates: Relationship to Circulating Placental Growth Factor. J Clin Endocrinol Metab 2005; 90: 4895–4903.
[15] Tsatsaris V, Goffin F, Munaut C, Brichant JF, Pignon MR, Noel A, et al. Overexpression of the soluble vascular endothelial growth factor receptor in preeclamptic patients: pathophysiological consequences. J Clin Endocrinol Metab 2003; 88: 5555–5563.
[16] Woodham PC, Brittain JE, Baker AM, Long DL, Haeri S, Camargo CA, et al. Midgestation maternal serum
25-hydroxyvitamin D level and soluble fms-like tyrosine kinase 1/placental growth factor ratio as predictors of
severe preeclampsia. Hypertension 2011; 58: 1120–1125.
[17] Erez O, Romero R, Espinoza J, Fu W, Todem D, Kusanovic JP, et al. The change in concentrations of angiogenic
and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-forgestational age. J Matern Fetal Neonatal Med 2008; 21:279–287.
[18] Kusanovic JP, Romero R, Chaiworapongsa T, Erez O, Mittal P, Vaisbuch E, et al. A prospective cohort study of the value of maternal plasma concentrations of angiogenic and antiangiogenic factors in early pregnancy and midtrimester in the identification of patients destined to develop preeclampsia. J Maternal Fetal Neonatal Med 2009; 22:1021–1038.
[19] Thadhani R, Mutter WP, Wolf M, Levine RJ, Taylor RN, Sukhatme VP, et al. First trimester placental growth
factor and soluble fms-like tyrosine kinase 1 and risk for preeclampsia. J Clin Endocrinol Metab 2004; 89: 770–775.
[20] Lim JH, Kim SY, Park SY, Yang JH, Kim MY, Ryu HM. Effective prediction of preeclampsia by a combined ratio
of angiogenesis-related factors. Obstet Gynecol 2008; 111:1403–1409.
[21] Haggerty CL, Seifert ME, Tang G, Olsen J, Bass DC, Karumanchi SA, et al. Second trimester anti-angiogenic
proteins and preeclampsia. Pregnancy Hypertens 2012; 2:158–163.
[22] Crispi F, Llurba E, Domínguez C, Martín-Gallán P, Cabero L, Gratacós E. Predictive value of angiogenic factors and uterine artery Doppler for early- versus late-onset preeclampsia and intrauterine growth restriction. UltrasoundObstet Gynecol 2008; 31: 303–309.
[23] March MI, Geahchan C, Wenger J, Raghuraman N, Berg A, Haddow H, et al. Circulating angiogenic factors and the risk of adverse outcomes among haitian women with preeclampsia. PloS One 2015; 10: e0126815.
[24] De Vivo A, Baviera G, Giordano D, Todarello G, Corrado F, D’Anna R. Endoglin, PlGF and sFlt-1 as markers for
predicting pre-eclampsia. Acta Obstet Gynecol Scand 2008; 87: 837–842.
[25] Sunderji S, Gaziano E, Wothe D, Rogers LC, Sibai B, Karumanchi SA, et al. Automated assays for sVEGF R1 and
PlGF as an aid in the diagnosis of preterm preeclampsia: a prospective clinical study. Am J Obstet Gynecol 2010;
202: 40.e1–7.
[26] Maynard SE, Min JY, Merchan J, Lim KH, Li J, Mondal S, et al. Excess placental soluble fms-like tyrosine kinase 1(sFlt1) may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia. J Clin Invest 2003;111: 649–658.
[27] Koga K, Osuga Y, Yoshino O, Hirota Y, Ruimeng X, Hirata T, et al. Elevated serum soluble vascular endothelial
growth factor receptor 1 (sVEGFR-1) levels in women with preeclampsia. J Clin Endocrinol Metab 2003; 88: 2348–
2351.
[28] Taylor RN, Grimwood J, Taylor RS, McMaster MT, Fisher SJ, North RA. Longitudinal serum concentrations of placental growth factor: Evidence for abnormal placental angiogenesis in pathologic pregnancies. Am J Obstet Gynecol 188:177–182.