Diagnostic accuracy of urinary PlGF levels for preeclampsia in pregnancy: Systematic review and meta-analysis of case-control studies
Keywords:
preeclampsia, placental growth factor, urinary biomarkers, pregnancy complications, diagnostic biomarkers, systematic review, meta-analysis, case-control studies, biomarker validation, pregnancy, placental proteinsAbstract
Background and aim: Despite growing interest in placental growth factor (PlGF) as a promising biomarker for preeclampsia, a comprehensive synthesis of urinary PlGF levels in this condition remains lacking. This systematic review and meta-analysis aim to quantify mean urinary PlGF levels (pg/mL) in women with preeclampsia compared to healthy controls, with and without creatinine adjustment.
Methods: A systematic search of five databases was conducted by two independent researchers using the following keywords: ""urine" AND "PlGF" OR "placental growth factor" AND "preeclampsia" OR "hypertensive disorders of pregnancy" OR "gestational hypertension," according to the standard guidelines. Studies were included if they provided the mean and standard deviation of urinary PlGF levels among pregnant women with preeclampsia and healthy controls, with or without creatinine adjustment.
Results: Seven articles were included. Five studies, encompassing seven groups, reported the mean urinary PlGF levels without creatinine adjustment. Using a random-effects model, the pooled mean PlGF level across these groups was 101.41 pg/mL (95% CI, 53.66–149.15) among healthy controls, compared with 32.24 pg/mL (95% CI, 21.48–43.02) in patients with preeclampsia. In three studies comprising five groups, the mean urinary PlGF levels were adjusted for creatinine. The pooled mean PlGF level for these groups, was 303.53 pg/mL (95% CI, 186.49–420.56) among healthy controls, versus 40.31 pg/mL (95% CI, 20.32–60.29) in patients with preeclampsia.
Conclusions: Our findings demonstrate significantly reduced urinary PlGF levels in preeclampsia regardless of creatinine adjustment, supporting its potential as a non-invasive diagnostic biomarker. Further research should establish standardized measurement protocols and clinical thresholds for implementation.
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