Glycosylated fibronectin in preeclampsia: a systematic review and meta-analysis

Abstract

Background: Preeclampsia (PE) is a complex multisystem disease, and its timely diagnosis and treatment impact the health of patients and perinatal infants. Studies have reported elevated levels of maternal serum glycosylated fibronectin (GlyFn) in patients with PE compared with pregnant women without PE (controls), suggesting its potential as a novel biomarker for screening and diagnosing PE. Therefore, this study aims to evaluate maternal serum GlyFn levels and their diagnostic accuracy in PE. Methods: A systematic literature search was conducted using PubMed, EMBASE, Web of Science, and the Cochrane Library up to January 15, 2024. The Newcastle-Ottawa Quality Assessment Scale and the Quality Assessment of Diagnostic Accuracy Studies-2 tool were used to evaluate study quality. Heterogeneity was assessed using I2 statistics. In the meta-analysis comparing maternal serum GlyFn levels between PE and controls, standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated. Publication bias was detected, and sensitivity and subgroup analyses were conducted to verify the robustness of the results and identify potential sources of heterogeneity. For the meta-analysis of diagnostic, the accuracy of maternal serum GlyFn levels between PE and controls, sensitivity and specificity were pooled and the summary receiver operating characteristic curve and area under the curve were used as measures of overall accuracy. This review was registered in the International Prospective Register of Systematic Reviews (registration number: CRD42024512172). Results: A total of 11 studies were included, and the meta-analysis revealed that maternal serum GlyFn levels were significantly higher in the PE group than in the control group (SMD = 1.08, 95% CI = 0.72–1.43, P < 0.001). Heterogeneity may arise from differences in the detection method and research type. Overall, the combined sensitivity and specificity of maternal serum GlyFn levels in diagnosing PE were 0.81 (95% CI = 0.77–0.85, P < 0.001) and 0.80 (95% CI = 0.77–0.82, P < 0.001), respectively, with an area under the curve of 0.90. Conclusions: This meta-analysis confirmed that maternal serum GlyFn levels are significantly higher in patients with PE and exhibit high diagnostic accuracy for PE diagnosis, suggesting its potential as a biomarker for screening and diagnosing PE.