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Meta-Analysis
. 2021 Jun 10:12:619530.
doi: 10.3389/fendo.2021.619530. eCollection 2021.

Predictive Performance of Serum β-hCG MoM Levels for Preeclampsia Screening: A Meta-Analysis

Xiao Zhang  1 , Zhao Huangfu  2 , Fangxin Shi  1 , Zhen Xiao  1   3
Affiliations
Meta-Analysis

Predictive Performance of Serum β-hCG MoM Levels for Preeclampsia Screening: A Meta-Analysis

Xiao Zhang et al. Front Endocrinol (Lausanne). .

Abstract

Objective: The aim of the present study was to investigate the predictive value of using the multiple of the median (MoM) of β-human chorionic gonadotropin (β-hCG) levels in patients with preeclampsia (PE) and healthy pregnant women.

Methods: Electronic databases including PubMed, EBSCO, Ovid, Web of Science, China National Knowledge Infrastructure (CNKI), SinoMed, Wangfang and the Weipu Journal were searched up to May 31, 2020. Two reviewers independently selected the articles and extracted data on study characteristics, quality and results. A random-effects model was employed, and standardized mean difference and 95% confidence intervals were calculated. Twenty-one case-control studies were analyzed in the present meta-analysis, including a total of 2,266 cases and 25,872 healthy controls.

Results: Women who were diagnosed with PE were found to have higher early second-trimester levels of serum β-hCG MoM compared with healthy controls, although the levels in the first trimester were not significantly different. Ethnicity subgroup analysis demonstrated that the MoM of β-hCG serum levels was significantly higher in PE patients in both Asian and Caucasian populations during the early second trimester.

Conclusion: The MoM of β-hCG serum levels was found to be a valuable clinical indicator for predicting PE in the early second trimester, but had little predictive value in the first trimester. However, further assessment of the predictive capacity of β-hCG within larger, diverse populations is required.

Keywords: early second trimester; meta-analysis; prediction; preeclampsia; β-hCG MoM levels.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart showing the results of the search strategy.
Figure 2
Figure 2
Random-effect model forest plot for the association between serum β-hCG MoM levels and PE.
Figure 3
Figure 3
Random-effect forest plot for the subgroup analysis according to (A) sample size, (B) ethnicity, (C) diagnostic criteria for PE, (D) detection period.
Figure 4
Figure 4
Random-effect forest plot for the subgroup analysis for the association between serum β-hCG MoM levels in the early second trimester and PE according to (A) sample size, (B) ethnicity, (C) diagnostic criteria for PE.
Figure 5
Figure 5
Meta-regression analysis on (A) ethnicity, (B) country, (C) diagnostic criteria for PE, (D) detection method, (E) sample size, (F) year of publication and (G) detection period on the basis of the 21 included case-control.
Figure 6
Figure 6
(A) Sensitivity analysis of the summary odds ratio coefficients on the difference of free β-hCG MoM values between PE and control subjects. (B) Funnel plot of publication biases on the difference of free β-hCG MoM values between PE and control subjects. (C) Galbraith plot of publication biases on the difference of free β-hCG MoM values between PE and control subjects.
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