The diagnostic potential of oxidative stress biomarkers for preeclampsia: systematic review and meta-analysis

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Abstract

Background

Preeclampsia is a multifactorial cardiovascular disorder of pregnancy. If left untreated, it can lead to severe maternal and fetal outcomes. Hence, timely diagnosis and management of preeclampsia are extremely important. Biomarkers of oxidative stress are associated with the pathogenesis of preeclampsia and therefore could be indicative of evolving preeclampsia and utilized for timely diagnosis. In this study, we conducted a systematic review and meta-analysis to determine the most reliable oxidative stress biomarkers in preeclampsia, based on their diagnostic sensitivities and specificities as well as their positive and negative predictive values.

Methods

A systematic search using PubMed, ScienceDirect, ResearchGate, and PLOS databases (1900 to March 2021) identified nine relevant studies including a total of 343 women with preeclampsia and 354 normotensive controls.

Results

Ischemia-modified albumin (IMA), uric acid (UA), and malondialdehyde (MDA) were associated with 3.38 (95% CI 2.23, 4.53), 3.05 (95% CI 2.39, 3.71), and 2.37 (95% CI 1.03, 3.70) odds ratios for preeclampsia diagnosis, respectively. The IMA showed the most promising diagnostic potential with the positive predictive ratio (PPV) of 0.852 (95% CI 0.728, 0.929) and negative predictive ratio (NPV) of 0.811 (95% CI 0.683, 0.890) for preeclampsia. Minor between-study heterogeneity was reported for these biomarkers (Higgins’ I ² = 0–15.879%).

Conclusions

This systematic review and meta-analysis identified IMA, UA, and MDA as the most promising oxidative stress biomarkers associated with established preeclampsia. IMA as a biomarker of tissue damage exhibited the best diagnostic test accuracy. Thus, these oxidative stress biomarkers should be further explored in larger cohorts for preeclampsia diagnosis.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s13293-022-00436-0.

Highlights

Biomarkers of oxidative stress are related to the pathogenesis of preeclampsia and might be indicative of evolving preeclampsia and utilized for timely diagnosis and management of preeclampsia.
Systematic review and meta-analysis were conducted to evaluate the diagnostic accuracy of oxidative stress markers based on their diagnostic sensitivities and specificities.
Clinically relevant positive predictive values (PPVs) and negative predictive values (NPVs) were determined for each biomarker.
IMA, UA, and MDA were associated with 3.38, 3.05, and 2.37 odds ratios for preeclampsia onset.
IMA exhibited the most promising diagnostic potential with an average PPV of 0.852 and NPV of 0.811, respectively. Minor heterogeneity was reported for these biomarkers (Higgins’ I ² = 0–15.879%).
These oxidative stress markers should be further explored in larger cohorts for preeclampsia diagnosis.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13293-022-00436-0.

Related collections

Most cited references 56

Record: found
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Article: not found

Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement

David Moher, Alessandro Liberati, Jennifer Tetzlaff … (2012)

David Moher and colleagues introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses

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Record: found
Abstract: found
Article: not found

QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies.

Penny F Whiting, Anne W S Rutjes, Marie E Westwood … (2011)

In 2003, the QUADAS tool for systematic reviews of diagnostic accuracy studies was developed. Experience, anecdotal reports, and feedback suggested areas for improvement; therefore, QUADAS-2 was developed. This tool comprises 4 domains: patient selection, index test, reference standard, and flow and timing. Each domain is assessed in terms of risk of bias, and the first 3 domains are also assessed in terms of concerns regarding applicability. Signalling questions are included to help judge risk of bias. The QUADAS-2 tool is applied in 4 phases: summarize the review question, tailor the tool and produce review-specific guidance, construct a flow diagram for the primary study, and judge bias and applicability. This tool will allow for more transparent rating of bias and applicability of primary diagnostic accuracy studies.

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Is Open Access

Global causes of maternal death: a WHO systematic analysis.

Lale Say, Doris Chou, Alison Gemmill … (2014)

Data for the causes of maternal deaths are needed to inform policies to improve maternal health. We developed and analysed global, regional, and subregional estimates of the causes of maternal death during 2003-09, with a novel method, updating the previous WHO systematic review. We searched specialised and general bibliographic databases for articles published between between Jan 1, 2003, and Dec 31, 2012, for research data, with no language restrictions, and the WHO mortality database for vital registration data. On the basis of prespecified inclusion criteria, we analysed causes of maternal death from datasets. We aggregated country level estimates to report estimates of causes of death by Millennium Development Goal regions and worldwide, for main and subcauses of death categories with a Bayesian hierarchical model. We identified 23 eligible studies (published 2003-12). We included 417 datasets from 115 countries comprising 60 799 deaths in the analysis. About 73% (1 771 000 of 2 443 000) of all maternal deaths between 2003 and 2009 were due to direct obstetric causes and deaths due to indirect causes accounted for 27·5% (672 000, 95% UI 19·7-37·5) of all deaths. Haemorrhage accounted for 27·1% (661 000, 19·9-36·2), hypertensive disorders 14·0% (343 000, 11·1-17·4), and sepsis 10·7% (261 000, 5·9-18·6) of maternal deaths. The rest of deaths were due to abortion (7·9% [193 000], 4·7-13·2), embolism (3·2% [78 000], 1·8-5·5), and all other direct causes of death (9·6% [235 000], 6·5-14·3). Regional estimates varied substantially. Between 2003 and 2009, haemorrhage, hypertensive disorders, and sepsis were responsible for more than half of maternal deaths worldwide. More than a quarter of deaths were attributable to indirect causes. These analyses should inform the prioritisation of health policies, programmes, and funding to reduce maternal deaths at regional and global levels. Further efforts are needed to improve the availability and quality of data related to maternal mortality. © 2014 World Health Organization; licensee Elsevier. This is an Open Access article published without any waiver of WHO's privileges and immunities under international law, convention, or agreement. This article should not be reproduced for use in association with the promotion of commercial products, services, or any legal entity. There should be no suggestion that WHO endorses any specific organisation or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.

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Author and article information

Contributors

Dinara Afrose: mstdinara.afrose@student.uts.edu.au

Hao Chen: hao.chen-17@student.uts.edu.au

Amali Ranashinghe: toama90@gmail.com

Chia-chi Liu: chia-chi.liu@sydney.edu.au

Annemarie Henessy: An.Hennessy@westernsydney.edu.au

Philip M. Hansbro: Philip.Hansbro@uts.edu.au

Lana McClements:

ORCID: http://orcid.org/0000-0002-4911-1014

lana.mcclements@uts.edu.au

Journal

Journal ID (nlm-ta): Biol Sex Differ

Journal ID (iso-abbrev): Biol Sex Differ

Title: Biology of Sex Differences

Publisher: BioMed Central (London )

ISSN (Electronic): 2042-6410

Publication date (Electronic): 4 June 2022

Publication date PMC-release: 4 June 2022

Publication date Collection: 2022

Volume: 13

Electronic Location Identifier: 26

Affiliations

[1 ]GRID grid.117476.2, ISNI 0000 0004 1936 7611, School of Life Sciences & Institute for Biomedical Materials and Devices (IBMD), Faculty of Science, , University of Technology Sydney, ; Ultimo, NSW 2007 Australia

[2 ]Centre for Inflammation, Centenary Institute, and University of Technology Sydney, Faculty of Science, Sydney, NSW 2050 Australia

[3 ]GRID grid.8065.b, ISNI 0000000121828067, Faculty of Science, , University of Colombo, ; Colombo 03, Sri Lanka

[4 ]GRID grid.1076.0, ISNI 0000 0004 0626 1885, The Heart Research Institute, University of Sydney, ; Newtown, NSW Australia

[5 ]GRID grid.1029.a, ISNI 0000 0000 9939 5719, School of Medicine, , Western Sydney University, ; Campbelltown, Australia

[6 ]GRID grid.460708.d, ISNI 0000 0004 0640 3353, Campbelltown Hospital, South Western Sydney Local Health District, ; Warwick Farm, Australia

Author information

Lana McClements http://orcid.org/0000-0002-4911-1014

Article

Publisher ID: 436

DOI: 10.1186/s13293-022-00436-0

PMC ID: 9167545

PubMed ID: 35658944

SO-VID: f17a70d8-ea10-4842-8071-858e9b47dd09

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 24 February 2022

Date accepted : 20 May 2022

Funding

Funded by: Australian Government Research Training Program (RTP)

Funded by: FundRef http://dx.doi.org/10.13039/501100000925, National Health and Medical Research Council;

Award ID: 1175134

Award Recipient : Philip M. Hansbro

Custom metadata

ScienceOpen disciplines: Human biology

Keywords: preeclampsia,oxidative stress,heavy metals,biomarkers,mda,ima,uric acid

Data availability:

ScienceOpen disciplines: Human biology

Keywords: preeclampsia, oxidative stress, heavy metals, biomarkers, mda, ima, uric acid

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The diagnostic potential of oxidative stress biomarkers for preeclampsia: systematic review and meta-analysis

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Abstract

Background

Methods

Results

Conclusions

Graphical Abstract

Supplementary Information

Highlights

Supplementary Information

Related collections

Journal of Circulating Biomarkers

Most cited references 56

Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement

QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies.

Global causes of maternal death: a WHO systematic analysis.

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