A Systematic Review of First Trimester Biochemical and Molecular Predictive Tests for Preeclampsia

Background: Preeclampsia is a multisystem disorder affecting 5%-8% of pregnant women. Considering the ongoing debate over the predicting value of some commercial first trimester tests, the aim of this study was to compare the existing first-trimester screening tests for preeclampsia.

Methods: In this systematic review, relevant articles published during 2000-2017 were extracted from PubMed, Science Direct, Scopus, Cochrane Library, ISI Web of Science, and ProQuest databases. After a thorough evaluation of the 412 potentially eligible papers, only 28 papers were selected based on the inclusion criteria.

Results: From a total of 412 retrieved studies, 28 papers were found eligible. Most studies had casecontrol or nested case-control designs. A total of 15164 pregnant women were evaluated in the reviewed studies. Various tests were applied in the first trimester of pregnancy to predict the development of preeclampsia. The most commonly used biomarkers were uterine artery pulsatility index, pregnancy-associated plasma protein A (PAPP-A), adiponectin, human chorionic gonadotropin (hCG) hormone and inhibin-A. Other tests were used in only one or two studies.

Conclusion: Based on this review, a combination of markers should be evaluated for the identification of high-risk women. Novel methods measuring multiple markers will hopefully facilitate the development of clinically effective screening programs in the future.