Association between placenta accreta spectrum and third‐trimester serum levels of vascular endothelial growth factor, placental growth factor, and soluble Fms‐like tyrosine kinase‐1: A meta‐analysis. Issue 9 (20th June 2022)

• Record Type: Journal Article
• Authors: Alzoubi, Osama; Maaita, Ward; Madain, Zaid; Alzoubi, Mohammad; Sweis, Jaleel J. G.; Arar, Ahmad R.; Sweis, Nabil W. G.
• Is Part Of: Journal of obstetrics and gynaecology research. Volume 48:Issue 9(2022)
• Page Start: 2363
• Page End: 2376
• Publication Date: 2022-06-20
• Subjects: biomarkers -- meta‐analysis -- placenta accreta -- vascular endothelial growth factor A -- vascular endothelial growth factor receptor‐1; Gynecology -- Periodicals; Obstetrics -- Periodicals; 618.1005
• DOI: 10.1111/jog.15330
• Languages: English
• ISSNs: 1341-8076

Abstract

Abstract: Aim: Antenatal suspicion of placenta accreta spectrum (PAS) currently relies on ultrasonographic findings, color doppler, and MRI, which have rendered it operator and expertise‐dependent. No serum markers for PAS have been integrated into clinical practice yet. The aim of this meta‐analysis was to identify potential serum markers for PAS by investigating third‐trimester serum levels of vascular endothelial growth factor (VEFG), placental growth factor (PIGF), and soluble Fms‐like tyrosine kinase‐1 (sFlt‐1) among PAS‐cases and controls. Methods: PubMed, Scopus, EBSCO, Web of Science, and CNKI databases were systematically searched for relevant articles. Random‐effects model was applied to calculate the overall standardized mean difference (SMD) for each marker. Subgroup analysis and meta‐regression were performed to assess for potential covariates. Results: Eight studies involving 366 PAS‐cases and 518 controls were included. Third trimester sFlt‐1 levels were significantly lower in PAS‐cases when compared to controls (SMD = −7.76, 95%CI = −10.42 to −5.10). This was, to a certain extent, consistent among studies though they differed in their extent of significance. Levels of VEGF (SMD = 1.59, 95%CI = −0.07 to 3.25) and PlGF (SMD = −0.49, 95%CI = −1.66 to 0.67) were not significantly different between PAS cases and controls, in which studies demonstrated conflicting results. Conclusions: Third trimester sFlt‐1 levels may be useful to predict PAS. Nonetheless, further studies are recommended to better understand conflicting results before adopting either VEGF or PlGF.