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

Abstract

Background 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 18 March 2021. Observational studies that assessed differences in serum LDH levels among women with hypertensive disorders of pregnancy and healthy controls were included. Meta‐analysis was performed using 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 5340 women with hypertensive disorders of pregnancy and 2890 healthy controls. The meta‐analysis revealed significant differences among patients with preeclampsia (either mild or severe) compared with 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. Conclusion 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.

Predictive Value Analysis of Serum sFlt-1 and PLGF Levels/Ratio in Preeclampsia

“…Previous studies have shown that serum lactate dehydrogenase (LDH), as a biochemical indicator for hypertension in pregnancy, has a sensitivity of 71% and a specificity of 74%. The average LDH level of patients with eclampsia is statistically higher than those with severe PE [42]. Therefore, LDH might have certain clinical significance in assessing the progress and severity of hypertension during pregnancy [43].…”

Pre-pregnancy body mass index combined with peripheral blood PLGF, DCN, LDH, and UA in a risk prediction model for pre-eclampsia

“…Studies have shown that LDH levels in the blood of PE patients are often significantly elevated, which may be related to vascular endothelial cell damage, tissue hypoxia and so on. Therefore, LDH test can be used as one of the blood biochemical indexes for PE patients in the acute stage ( 7 ). Uric acid (UA) is an indicator that is routinely measured in metabolic diseases such as nephropathy.…”