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Journal of Extracellular Vesicles Nov 2023Extracellular vesicles (EVs) play a crucial role in pregnancy, revealed by the presence of placental-derived EVs in maternal blood, their in vitro functionality, and... (Review)
Review
Extracellular vesicles (EVs) play a crucial role in pregnancy, revealed by the presence of placental-derived EVs in maternal blood, their in vitro functionality, and their altered cargo in pregnancy pathologies. These EVs are thought to be involved in the development of pregnancy pathologies, such as pre-eclampsia, pre-term birth, and fetal growth restriction, and have been suggested as a source of biomarkers for gestational diseases. However, to accurately interpret their function and biomarker potential, it is necessary to critically evaluate the EV isolation and characterization methodologies used in pregnant cohorts. In this systematic scoping review, we collated the results from 152 studies that have investigated EVs in the blood of pregnant women, and provide a detailed analysis of the EV isolation and characterization methodologies used. Our findings indicate an overall increase in EV concentrations in pregnant compared to non-pregnant individuals, an increased EV count as gestation progresses, and an increased EV count in some pregnancy pathologies. We highlight the need for improved standardization of methodology, greater focus on gestational changes in EV concentrations, and further investigations into the functionality of EVs. Our review suggests that EVs hold great promise as diagnostic and translational tools for gestational diseases. However, to fully realize their potential, it is crucial to improve the standardization and reliability of EV isolation and characterization methodologies, and to gain a better understanding of their functional roles in pregnancy pathologies.
Topics: Pregnancy; Female; Humans; Extracellular Vesicles; Placenta; Reproducibility of Results; Pre-Eclampsia
PubMed: 37974377
DOI: 10.1002/jev2.12377 -
PloS One 2023Preeclampsia is a serious condition that is linked to poor perinatal outcomes. In Ethiopia, the overall prevalence of preeclampsia and its associated factors is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Preeclampsia is a serious condition that is linked to poor perinatal outcomes. In Ethiopia, the overall prevalence of preeclampsia and its associated factors is uncertain. Therefore, the purpose of this review was to find the prevalence of pre-eclampsia and its determinants in Ethiopia.
METHODS
To find primary studies, PubMed, Google Scholar, HINAR, Scopus, the Web of Sciences, and grey literature searches were used between January 1, 2013, and January 1, 2023, in Ethiopia. A Microsoft Excel sheet was used to extract data. The pooled prevalence of pre-eclampsia was predicted using a random-effect model.
RESULTS
Twenty-nine studies were included. The pooled prevalence of pre-eclampsia was 11.51% (95% CI: 8.41, 14.61). Age > 35 years old (AOR = 2.34, 95%CI, 1.74-2.94; p-value = 0.64), housewife (AOR = 2.76, 95%CI, 1.2-4.32; p-value = 0.37), previous history of pre-eclampsia (AOR = 4.02, 95%CI, 2.91-5.55; p-value = 0.09), family history of hypertension (OR = 1.84, 95%CI, 1.39-2.3; p-value = 0.4), history of chronic hypertension (AOR = 2.44, 95%CI, 1.8-3.08; p-value = 0.67), history of multiple pregnancies (AOR = 1.45, 95%CI, 1.09-1.8; p-value = 0.38), and alcohol intake during pregnancy (AOR = 1.53, 95%CI, 1.03-2.04; p-value = 0.03) were the determinants of pre-eclampsia.
CONCLUSIONS
When compared to previous studies, the overall pooled prevalence of pre-eclampsia was high. Pre-eclampsia is associated with maternal age >35 years, being a housewife, having a history of preeclampsia, having a history of chronic hypertension, having a family history of hypertension, having diabetes mellitus, drinking alcohol during pregnancy, and having multiple pregnancies.
Topics: Pregnancy; Female; Humans; Adult; Pre-Eclampsia; Ethiopia; Risk Factors; Maternal Age; Hypertension; Prevalence
PubMed: 37963147
DOI: 10.1371/journal.pone.0287038 -
Pregnancy Hypertension Dec 2023Human chorionic gonadotropin (hCG), a glycoprotein produced in the placenta, is crucial for a healthy pregnancy. We investigated the relationship between hCG levels and... (Meta-Analysis)
Meta-Analysis Review
Human chorionic gonadotropin (hCG), a glycoprotein produced in the placenta, is crucial for a healthy pregnancy. We investigated the relationship between hCG levels and adverse pregnancy outcomes. We conducted a systematic review including studies measuring hCG blood levels in the first or second trimester, reporting on any of the 12 predefined adverse pregnancy outcomes with logistic regression-adjusted association estimates. The primary outcomes were placenta-associated complications, such as miscarriage, preeclampsia, intrauterine growth restriction, and preterm delivery. We searched PubMed, Embase and CINAHL Complete. The hCG levels were analysed as multiple of the median (MoM). Odds ratio (OR) and 95% confidence interval (CI) were used. Risk of bias and the certainty of evidence were assessed using ROBINS-I and GRADE, respectively. Meta-analysis also showed that hCG levels, reported as MoM ≥2/2.31/2.5, might be associated with an increased risk of preeclampsia (OR 2.08, 95% CI 1.26 to 3.44) and preterm delivery (OR 1.29, 95% CI 1.12 to 1.47), but the evidence is very uncertain. High second trimester hCG levels may be associated with preeclampsia and preterm delivery but confidence in evidence is low.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Premature Birth; Pre-Eclampsia; Pregnancy Outcome; Chorionic Gonadotropin; Abortion, Spontaneous; Pregnancy Trimester, Second
PubMed: 37951184
DOI: 10.1016/j.preghy.2023.11.003 -
Women and Birth : Journal of the... Feb 2024Over 25000 Australian women smoke during pregnancy each year, with risks to mother and baby including miscarriage, pre-eclampsia, placental issues, premature birth, and... (Review)
Review
PROBLEM
Over 25000 Australian women smoke during pregnancy each year, with risks to mother and baby including miscarriage, pre-eclampsia, placental issues, premature birth, and stillbirth.
BACKGROUND
Carbon Monoxide testing has been introduced in antenatal care settings to help identify smokers and motivate them to quit.
AIM
This integrative systematic review aims to take a holistic look at Carbon Monoxide (CO) testing to understand how effective and acceptable this practice is in antenatal care.
METHODS
PubMed, Scopus and CINAHL were searched for literature relating to pregnant women where CO testing has been used to identify smoking as part of a smoking cessation initiative. The search results were then screened and reviewed independently by two authors. A total of 15 studies were deemed relevant and proceeded to quality appraisal using the Crowe Critical Appraisal Tool. A Narrative Synthesis method was used to present the findings.
DISCUSSION
Synthesis resulted in four themes: smoking identification and referral to cessation support, smoking cessation, midwifery usability of CO testing and women's perception of CO testing. Whilst carbon monoxide testing increased the identification and referral to cessation support for pregnant smokers, it did not make an overall difference to smoking cessation rates. Midwives frequently report having too little time to conduct carbon monoxide testing. Findings suggest that women accept the test, but their opinions are under-represented in the existing evidence. Midwives and women report concern for the midwife/woman relationship if testing is not conducted well.
CONCLUSION
Whilst carbon monoxide testing can identify smoking, it does not appear to motivate pregnant smokers to quit.
Topics: Female; Humans; Pregnancy; Australia; Carbon Monoxide; Placenta; Prenatal Care; Smoking; Smoking Cessation
PubMed: 37932159
DOI: 10.1016/j.wombi.2023.10.008 -
Immunity, Inflammation and Disease Oct 2023Recurrent pregnancy loss (RPL) and pre-eclampsia (PE) are immune-related pregnancy complications that have been linked to CD4 T cells and their cytokines, which can be... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Recurrent pregnancy loss (RPL) and pre-eclampsia (PE) are immune-related pregnancy complications that have been linked to CD4 T cells and their cytokines, which can be influenced by genetic polymorphisms. This meta-analysis aimed to investigate the relationship between interleukin (IL)-17 and -27 polymorphisms and the susceptibility to RPL and PE.
METHODS
All eligible case-control studies published up to February 2023 were identified by searching PubMed, EMBASE, Cochrane, Web of Science, and Google Scholar. The risk of recurrent pregnancy loss and PE associated with the IL-17 rs2275913, IL-17 rs763780, IL-27 rs153109, and IL-27 rs17855750 polymorphisms were estimated for each study.
RESULTS
The meta-analysis incorporated a total of 13 studies. The overall analysis indicated that IL-17 rs2275913, IL-17 rs763780, IL-27 rs153109, and IL-27 rs17855750 polymorphisms were not significantly associated with immune-related pregnancy complications, including RPL and PE. However, when the analysis was stratified by disease type, the IL-17 rs2275913 polymorphism was found to be associated with an increased risk of RPL (recessive model AA/GA + GG: OR = 1.68, 95% confidence interval [CI]: 1.13-2.49, p = .01).
CONCLUSIONS
The IL-17 rs763780, IL-27 rs153109, and IL-27 rs17855750 polymorphisms were not significantly associated with RPL and PE, whereas the IL-17 rs2275913 polymorphism was associated with the susceptibility to recurrent miscarriage.
Topics: Female; Humans; Pregnancy; Abortion, Habitual; Interleukin-17; Interleukin-27; Interleukins; Polymorphism, Genetic; Pre-Eclampsia
PubMed: 37904702
DOI: 10.1002/iid3.1057 -
Frontiers in Cardiovascular Medicine 2023Pre-eclampsia (PE) is a severe pregnancy complication. Thrombocytopenia and platelet dysfunction are common hematology disorders in PE. Previous studies considered mean... (Review)
Review
BACKGROUND
Pre-eclampsia (PE) is a severe pregnancy complication. Thrombocytopenia and platelet dysfunction are common hematology disorders in PE. Previous studies considered mean platelet volume (MPV), a functional marker of platelets, as a potentially useful predictor for the diagnosis of PE.
METHODS
PubMed, China Biomedical Literature Database, Chinese National Knowledge Infrastructure, Embase, Wanfang, VIP, and Cochrane Library databases were searched to gather diagnostic trials evaluating the diagnosis of PE using MPV, from their inception to 13 March 2023. We also searched Google Scholar and Baidu.
RESULTS
A total of 22 studies from 20 articles were found. The pooled diagnostic accuracy of the MPV for PE recognition was as follows: sensitivity (SEN) 0.676 [95% confidence interval (CI) (0.658-0.694)], specificity (SPE) 0.710 [95% CI (0.703-0.717)], and diagnostic odds ratio (DOR) 7.012 [95% CI (4.226-11.636)], and the SROC-AUC and Q* indices were 0.7889 and 0.7262, respectively. The pooled SEN, SPE, and DOR of the diagnostic accuracy of MPV for PE before 16 weeks of gestation were 0.707 [95% CI (0.670-0.743)], 0.639 [95% CI (0.611-0.667)], and 4.026 [95% CI (2.727-5.943)], and the SROC-AUC and Q* indices were 0.7278 and 0.6753, respectively. For the interval of truncation values between 9 and 10 fl, the SROC-AUC and Q* indices for MPV were 0.8856 and 0.8162, respectively.
CONCLUSIONS
Available evidence suggests that MPV has a moderate predictive and diagnostic value for PE, particularly in diagnosing after 20 weeks of gestation. The diagnostic accuracy is higher when the MPV cut-off falls between 9 and 10 fl. The sensitivity of MPV alone in diagnosing PE is not high, and the combination of other markers for predictive diagnosis may better differentiate PE.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023425154, identifier: CRD42023425154.
PubMed: 37868773
DOI: 10.3389/fcvm.2023.1251304 -
Health Science Reports Oct 2023The aim of this meta-analysis was to find the association between periodontal disease (PD) and the risk of adverse pregnancy outcomes, including Pre-eclampsia (PE),...
BACKGROUND AND AIM
The aim of this meta-analysis was to find the association between periodontal disease (PD) and the risk of adverse pregnancy outcomes, including Pre-eclampsia (PE), premature rupture of the amniotic sac, gestational diabetes (GDM), or low birth weight (LBW) in pregnant women, which should be investigated in a systematic meta-analysis.
METHODS
Studies that reported the association between PD and pregnancy or neonatal outcomes and were published from January 1990 to December 2022, were identified by an extensive search in PubMed (Medline), Scopus, Web of Sciences, and Medline (Elsevier). After retrieving the studies, the screening stage was performed based on their titles, abstracts, and full texts, and after selecting the final articles, their information was extracted and their quality was assessed using the Newcastle Ottawa Scale checklist.
RESULTS
Pregnant women with PD had a 1.39 higher chance of developing GDM than those who did not have the infection (risk ratio [RR]: 1.39; 95% confidence interval [CI]: 1.21-1.61; I square: 49.67%; : 0.03). Additionally, the pooled RR of LBW was 2.19, which indicates that pregnant women with PD had a 2.19-fold higher risk of LBW than pregnant women who do not have the infection (RR: 2.19; 95% CI: 1.82-2.64; I square: 0.00%; : 0.65). The relationship between the risk of PE and the existence of PD was examined in 33 cohort and case-control studies for this meta-analysis. These results were combined, and the pooled RR was 1.43. This indicates that pregnant women with PD are 1.43 times more likely to experience PE than pregnant women without PD (RR: 1.43; 95% CI: 1.32-1.54; I square: 82.64%; : 0.00).
CONCLUSION
According to the findings of the current meta-analysis, PD may contribute to a higher risk of poor maternal and newborn outcomes in pregnant women.
PubMed: 37867783
DOI: 10.1002/hsr2.1630 -
Lipids in Health and Disease Oct 2023Preeclampsia (PE) is a new-onset pregnancy-specific disorder with a high prevalence that leads to over 70 000 maternal and 500 000 foetal fatalities worldwide each year.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Preeclampsia (PE) is a new-onset pregnancy-specific disorder with a high prevalence that leads to over 70 000 maternal and 500 000 foetal fatalities worldwide each year. The level of chemerin, a newly identified adipokine, is increased in diabetic and obese patients. Currently, there are several studies describing the relationship between maternal circulating chemerin levels and PE. Therefore, this study aimed to assess their association in pooled samples.
METHODS
Four databases were systematically searched to identify potential studies that reported circulating chemerin levels in PE and normal pregnancy groups. Standardized mean differences (SMDs), 95% confidence intervals (CIs), and 95% prediction intervals (PIs) were calculated using a random-effects meta-analysis. The probability of heterogeneity was also investigated by sensitivity analysis, subgroup analysis, and meta-regression.
RESULTS
Thirteen studies in 11 articles with a total of 860 PE patients and 1309 women with normal pregnancies met the inclusion criteria. The results of the meta-analysis revealed that circulating chemerin, which levels in PE patients were considerably higher than those in controls (SMD = 1.39, 95% CI: 1.02, 1.77, 95% PI: -0.07, 2.86). Moreover, sensitivity analysis determined that the outcomes of the overall pooled results were not affected after the elimination of any study. Notably, subgroup analysis demonstrated a similar expression pattern irrespective of geographic location, severity, timing of sampling, and sample size. Last, there were no factors that significantly impacted the overall estimate, according to meta-regression.
CONCLUSIONS
This meta-analysis is the first to assess circulating chemerin levels in PE patients. The findings indicate that circulating chemerin levels may be a potential marker to diagnose PE.
Topics: Pregnancy; Humans; Female; Pre-Eclampsia; Adipokines; Fetus
PubMed: 37864182
DOI: 10.1186/s12944-023-01941-w -
Nutrients Sep 2023Although gestational diabetes mellitus (GDM) has several short- and long-term adverse effects on the mother and the offspring, no medicine is generally prescribed to... (Meta-Analysis)
Meta-Analysis Review
Although gestational diabetes mellitus (GDM) has several short- and long-term adverse effects on the mother and the offspring, no medicine is generally prescribed to prevent GDM. The present systematic review and meta-analysis aimed to investigate the effect of inositol supplementation in preventing GDM and related outcomes. Systematic search was performed in CENTRAL, MEDLINE, and Embase until 13 September 2023. Eligible randomized controlled trials (RCTs) compared the efficacy of inositols to placebo in pregnant women at high risk for GDM. Our primary outcome was the incidence of GDM, whereas secondary outcomes were oral glucose tolerance test (OGTT) and maternal and fetal complications. (PROSPERO registration number: CRD42021284939). Eight eligible RCTs were identified, including the data of 1795 patients. The incidence of GDM was halved by inositols compared to placebo (RR = 0.42, CI: 0.26-0.67). Fasting, 1-h, and 2-h OGTT glucose levels were significantly decreased by inositols. The stereoisomer myoinositol also reduced the risk of insulin need (RR = 0.29, CI: 0.13-0.68), preeclampsia or gestational hypertension (RR = 0.38, CI: 0.2-0.71), preterm birth (RR = 0.44, CI: 0.22-0.88), and neonatal hypoglycemia (RR = 0.12, CI: 0.03-0.55). Myoinositol decrease the incidence of GDM in pregnancies high-risk for GDM. Moreover, myoinositol supplementation reduces the risk of insulin need, preeclampsia or gestational hypertension, preterm birth, and neonatal hypoglycemia. Based on the present study 2-4 g myoinositol canbe suggested from the first trimester to prevent GDM and related outcomes.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Diabetes, Gestational; Premature Birth; Pre-Eclampsia; Hypertension, Pregnancy-Induced; Randomized Controlled Trials as Topic; Hypoglycemia; Insulin; Inositol
PubMed: 37836508
DOI: 10.3390/nu15194224 -
Biomolecules & Biomedicine May 2024Chemerin is a multifunctional adipokine associated with systemic inflammation, angiogenesis, and oxidative stress. Emerging evidence suggests a potential link between... (Meta-Analysis)
Meta-Analysis
Chemerin is a multifunctional adipokine associated with systemic inflammation, angiogenesis, and oxidative stress. Emerging evidence suggests a potential link between chemerin and the pathogenesis of preeclampsia (PE). In this systematic review and meta-analysis, we aimed to evaluate the serum chemerin levels in women with PE. A systematic search was conducted across Medline, Web of Science, and Embase databases from inception until April 15, 2023, to identify studies comparing serum chemerin levels in pregnant women with and without PE. A random-effects model was employed to pool the results, accounting for heterogeneity. Thirteen datasets from 10 observational studies, encompassing 832 women with PE and 1298 healthy pregnant women, were analyzed. The pooled findings indicated a statistically significant elevation in serum chemerin levels in women with PE compared to controls (mean difference [MD] = 89.56 ng/mL, 95% confidence interval [CI] 62.14 - 116.98; P < 0.001; I2 = 87%). The subgroup analysis revealed consistent findings across studies that measured chemerin levels before or after the diagnosis of PE, studies that did or did not match the body mass index (BMI), and studies with varying quality scores (P values for subgroup differences were all > 0.05). Compared to controls, women with severe PE exhibited a significantly greater increase in serum chemerin levels than those with mild PE (P value for subgroup difference = 0.007). Additionally, meta-regression analysis results suggested that the mean BMI of the included pregnant women might positively modify the difference in circulating chemerin levels between women with and without PE (coefficient = 8.92; P = 0.045). In conclusion, this meta-analysis suggests a positive correlation between elevated serum chemerin levels and PE diagnosis in comparison to pregnant women without the condition.
Topics: Humans; Pre-Eclampsia; Female; Chemokines; Pregnancy; Biomarkers; Intercellular Signaling Peptides and Proteins
PubMed: 37782564
DOI: 10.17305/bb.2023.9671