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Meta-Analysis
. 2020 Dec 23;15(12):e0243538.
doi: 10.1371/journal.pone.0243538. eCollection 2020.

Maternal lipid profile and risk of pre-eclampsia in African pregnant women: A systematic review and meta-analysis

Endalamaw Tesfa  1   2 , Endalkachew Nibret  2   3 , Abaineh Munshea  2   3
Affiliations
Meta-Analysis

Maternal lipid profile and risk of pre-eclampsia in African pregnant women: A systematic review and meta-analysis

Endalamaw Tesfa et al. PLoS One. .

Abstract

Introduction: Some studies have reported the association between maternal serum lipid profile abnormalities and pre-eclampsia. However, many studies have reported controversial results. Hence, this systematic review and meta-analysis was planned to generate summarized evidence on the association between maternal serum lipid profiles and pre-eclampsia in African women.

Methods: Four electronic databases such as; PubMed, Hinari, Google Scholar, and African Journals Online were searched for studies published in English. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument and Newcastle-Ottawa Scale were used for data extraction and quality assessment of the included studies. The meta- regression analysis was performed by Stata 14 software. The standardized mean difference (SMD) values of lipid profiles were computed to assess their association with pre-eclampsia at 95% CI.

Results: In this review a total of 15 observational studies were included. The mean values of triglyceride (TG), total cholesterol (TC), low density lipoprotein- cholesterol (LDL-c) and very low density lipoprotein- cholesterol (VLDL-c) were significantly higher in pre-eclamptic women as compared with normotensive pregnant women (TG = 229.61±88.27 and 147.00 ± 40.47, TC = 221.46 ± 45.90 and 189.67 ± 39.18, LDL = 133.92 ± 38.77 and 112.41 ± 36.08, VLDL = 41.44 ± 19.68 and 26.64 ± 7.87), respectively. The serum high density lipoprotein cholesterol (HDL-c) level was lower, but it is not statistically significant (HDL-c = 51.02 ± 16.01 and 61.80 ± 25.63) in pre-eclamptic women as compared with controls. The pooled standardized mean difference (SMD) of TG, TC, LDL-C and VLDL-C were significantly increased in pre-eclamptic women as compared with normotensive pregnant women with the SMD of (TG = 1.65 (1.10, 2.21), TC = 0.84 (0.40, 1.29), LDL-C = 0.95 (0.46, 1.45) and VLDL-C = 1.27 (0.72, 1.81)) at 95% CI, respectively, but the pooled SMD of HDL-cholesterol was decreased in pre-eclamptic women as compared with normotensive pregnant women (SMD = -0.91 (95% CI: -1.43, -0.39).

Conclusions: In this review, the maternal serum levels of TG, TC, LDL-c and VLDL-c were significantly associated with the risk of preeclampsia. However, HDL- cholesterol was not significantly associated but it was lower in pre-eclamptic women. Further, large scale prospective studies should verify these outcomes and it is recommended that lipid profiles should be included as a routine diagnostic test for pre-eclamptic women.

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Conflict of interest statement

the authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram showing the included studies for the systematic review and meta-analysis of maternal lipid profile and pre-eclampsia.
Fig 2
Fig 2. Forest plot of standardized mean difference of total cholesterol and pre-eclampsia.
Fig 3
Fig 3. Forest plot of standardized mean difference of total triglycerides and pre-eclampsia.
Fig 4
Fig 4. Forest plot of standardized mean difference of HDL-cholesterol and pre-eclampsia.
Fig 5
Fig 5. Forest plot of standardized mean difference of LDL-cholesterol and pre-eclampsia.
Fig 6
Fig 6. Forest plot of standardized mean difference of VLDL-cholesterol and pre-eclampsia.
See this image and copyright information in PMC

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