Serum LDH values in hypertensive disorders of pregnancy and their association with maternal and neonatal morbidity: a meta-analysis

Abstract

Objectives: Serum lactate dehydrogenase has been extensively studied in hypertensive disorders of pregnancy. However, to date, its clinical usefulness in the field remains unknown. The present meta-analysis has been designed to evaluate differences in serum LDH values among patients with hypertensive disorders of pregnancy and to help determine its diagnostic accuracy as well its predictive accuracy in determining adverse pregnancy outcomes. Methods: We searched Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL and Google Scholar databases from their inception till March 18, 2021. Meta-analysis was performed using the meta and metafor functions in Rstudio. Pooled mean differences (MD) were calculated with the Hartung-Knapp-Sidik-Jonkman. Meta-regression analyses, publication bias assessment and Trim and Fill function were also performed. The adequacy of the sample size was evaluated with Trial Sequential Analysis. Results: Fifty-two articles were included that comprised 5,340 women with hypertensive disorders of pregnancy and 2,890 healthy controls. The meta-analysis revealed significant differences among patients with preeclampsia (either mild or severe) compared to controls, as well as among patients with mild and severe preeclampsia. Significant asymmetry was noted after examining funnel plots, however, and the trim and fill analysis revealed that differences were significant only among cases with severe preeclampsia and healthy controls. Morbidity outcomes increased with LDH levels > 600 IU/L and particularly when these exceeded 800 IU/L. However, confidence and prediction intervals indicated an underpowered sample size for the accurate determination of the odds of developing maternal morbidity. Conclusions: Despite the extensive research in the field of hypertensive disorders of pregnancy, there is still lack of evidence concerning the diagnostic performance of serum LDH in clinical practice; hence, research should expand in this direction to evaluate its clinical utility.

Evaluation of the relationship between preeclampsia and positive rectovaginal culture of group B Streptococcus and Helicobacter pylori positive serology

“…In our study, the levels of various factors, such as systolic and diastolic BPs, LDH, hemoglobin, creatinine, and platelets were significantly different in the healthy and preeclampsia groups, which was consistent with other studies (21,22). Various variables have been identified as blood markers in patients with preeclampsia which may be important in the treatment of patients with preeclampsia (21,23).…”

“…Hypertensive disorders occur in a high percentage of pregnant women and preeclampsia is the most serious hypertensive condition as well as the second DOI:10.34172/ipp.2022. 21 leading cause of maternal death in developing countries (6,7). Although the incidence of hypertension increases in the elderly, preeclampsia often affects young pregnant women (8).…”