Angiogenic factors and the risk of preeclampsia: A systematic review and meta-analysis

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) in the 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 X-2 test and quantified by I-2. 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