Exploring strengths and limits of urinary D-chiro inositol phosphoglycans (IPG-P) as a screening test for preeclampsia: A systematic review and meta-analysis. (September 2019)

• Record Type: Journal Article
• Authors: Scioscia, Marco; Noventa, Marco; Cavallin, Francesco; Straface, Gianluca; Pontrelli, Giovanni; Fattizzi, Nicola; Libera, Marco; Rademacher, Thomas W.; Robillard, Pierre-Yves
• Is Part Of: Journal of reproductive immunology. Volume 134/135(2019)
• Page Start: 21
• Page End: 27
• Publication Date: 2019-09
• Subjects: Pregnancy -- Preeclampsia -- Screening test -- Urine; Reproduction -- Immunological aspects -- Periodicals; Immunology -- Periodicals; Allergy and Immunology -- Periodicals; Reproduction -- Periodicals; Reproduction -- Immunologie -- Périodiques; Immunologie -- Périodiques; Immunology; Reproduction -- Immunological aspects; Periodicals; Electronic journals; Electronic journals; 615.766
• DOI: 10.1016/j.jri.2019.07.005
• Languages: English
• ISSNs: 0165-0378

Abstract

Highlights: Most maternal and fetal poor outcomes related to preeclampsia occur in low-income countries. A rapid noninvasive screening test for preeclampsia represents the first clinical priority. Inositol phosphoglycans P- shown to identify in advance most of the women who will develop preeclampsia. A meta-analysis revealed the potential of urinary IPG-P as a valid and inexpensive screening test for preeclampsia. Abstract: Preeclampsia is a severe complication of human pregnancy as it leads to significant maternal and perinatal mortality and morbidity worldwide. A prompt recognition of women that develop this syndrome can improve clinical management, increase surveillance and, finally, improve outcomes. Different methods (based on history, ultrasound, serum and urinary biomarkers) were proposed a screening tests for this disease but their performance showed limited results. Urinary inositol phosphoglycans P-type (IPG-P) were shown to identify in advance most of the women who will develop preeclampsia in case-control and longitudinal studies, so we undertook a systematic review and meta-analysis of published studies. Seven studies met the entry criteria so were evaluated. All case-control studies showed excellent statistical performances in a quality statistical assessment. The meta-analysis considered three longitudinal, prospective studies that showed high sensitivity and specificity with ranges of 0.82- 0.99 and 0.90–1.00, respectively. Univariate measures of accuracy revealed a positive and negative likelihood ratio respectively of 3.61 (95% CI 1.56–5.67) and -2.35 (95% CI -3.79 to -0.91). By univariate approach, we found a pooled logarithm of diagnostic odds ratio of 6.15 (95% CI 2.64–9.67). A limitation of this analysis is that, although conducted in different settings (UK, Italy, France, South Africa, and Mauritius) and different clinical groups, they were based on a single academic group. According to our findings, IPG-P test showed very encouraging results as a rapid noninvasive screening test for preeclampsia. Further studies are needed to verify and to validate the reported findings.