Highlights
Severe disease is not common in both pregnant women and neonates.
Perinatal transmission occurs rarely and may not be linked to disease severity.
Vertical transmission has been assumed in 4 cases.
Transmission risk is low when the infection manifests during the third trimester.
Further research should provide evidence about the risk of congenital infection.
Current evidence support the use of presepsin in the early neonatal period in high-risk populations as its diagnostic accuracy seems to be high in detecting neonatal sepsis. What is known: • Neonatal sepsis is a leading cause of morbidity and mortality. • Current laboratory tests cannot accurately discriminate endangered neonates. What is new: • The diagnostic odds ratio of presepsin is 170.28 and the area under the curve is 0.9751. • According to our meta-analysis, presepsin is a useful protein that may help clinicians identify neonates at risk.
This meta-analysis aims to compare serum uric acid levels among preeclamptic and healthy pregnant women across the various trimesters and provide a summary of the effect size of this biomarker in predicting adverse pregnancy outcomes. MEDLINE, Scopus, CENTRAL, Clinicaltrials.gov, and Google Scholar databases were systematically searched from inception. Observational studies were held eligible if they reported serum uric acid among preeclamptic and healthy pregnant women. Metaanalysis was conducted regarding uric acid concentration, diagnostic accuracy, and association with perinatal outcomes. The credibility of evidence was appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. The analysis included 196 studies, comprising 39 540 women.Preeclampsia was associated with significantly elevated uric acid levels during the 1st (mean difference [MD]: 0.21 mg/dL, 95% confidence intervals [CI]: 0.06-0.35) trimester, 2nd (MD: 1.41 mg/dL, 95% CI: 0.78-2.05) trimester, and 3rd (MD: 2.26 mg/dL, 95% CI: 2.12-2.40) trimester. Higher uric acid was estimated for severe preeclampsia, eclampsia, and hemolysis, elevated liver enzymes, low platelet syndrome. The sensitivity for adverse perinatal outcome prediction ranged from 67.3% to 82.7% and the specificity from 47.7% to 70.7%. In conclusion, it is suggested that serum uric acid levels are increased in preeclampsia and can be used to predict disease severity and pregnancy complications. Future prospective studies should verify these outcomes, assess the optimal cutoffs, and incorporate uric acid to combined predicting models.
S U PP O RTI N G I N FO R M ATI O NAdditional supporting information may be found online in the Supporting Information section. How to cite this article: Bellos I, Pergialiotis V, Loutradis D, Daskalakis G. The prognostic role of serum uric acid levels in preeclampsia: A meta-analysis. J Clin Hypertens. 2020;22: 826-834. https://doi.
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