Fibrinogen and D-dimer protein levels in patients with preeclampsia: a systematic review and meta-analysis

Abstract Introduction Preeclampsia (PE) is a significant obstetric and global health concern associated with fetal growth restriction, poor placental perfusion, and maternal organ dysfunction. Early detection through simple, routine antenatal indicators is essential. This systematic review and meta-...

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Main Authors: Ermiyas Alemayehu, Alemu Gedefie, Fasil Getu, Zewudu Mulatie, Muluken Walle, Ousman Mohammed, Getachew Mesfin Bambo, Habtu Debash, Yenealem Solomon, Abdurehman Eshete Mohammed, Hussen Ebrahim, Melaku Ashagrie Belete
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Pregnancy and Childbirth
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Online Access:https://doi.org/10.1186/s12884-025-07964-8
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author Ermiyas Alemayehu
Alemu Gedefie
Fasil Getu
Zewudu Mulatie
Muluken Walle
Ousman Mohammed
Getachew Mesfin Bambo
Habtu Debash
Yenealem Solomon
Abdurehman Eshete Mohammed
Hussen Ebrahim
Melaku Ashagrie Belete
author_facet Ermiyas Alemayehu
Alemu Gedefie
Fasil Getu
Zewudu Mulatie
Muluken Walle
Ousman Mohammed
Getachew Mesfin Bambo
Habtu Debash
Yenealem Solomon
Abdurehman Eshete Mohammed
Hussen Ebrahim
Melaku Ashagrie Belete
author_sort Ermiyas Alemayehu
collection DOAJ
description Abstract Introduction Preeclampsia (PE) is a significant obstetric and global health concern associated with fetal growth restriction, poor placental perfusion, and maternal organ dysfunction. Early detection through simple, routine antenatal indicators is essential. This systematic review and meta-analysis assessed fibrinogen (FIB) and D-dimer (DD) levels in PE patients compared to normotensive pregnant women. Methods Relevant articles were systematically identified through comprehensive searches across multiple databases such as PubMed, Scopus, Embase, and Hinari. Utilizing Stata version 14.0, we employed a random-effects model to estimate the pooled standardized mean difference (SMD) along with their corresponding 95% confidence intervals (CIs). Heterogeneity was assessed using I2 statistics and the Cochrane Q test, while subgroup analyses and meta-regression were conducted to investigate potential sources of heterogeneity. Additionally, sensitivity analysis was performed to assess the robustness of the findings. Furthermore, Egger’s regression test and funnel plot were utilized to evaluate publication bias among the included studies. Results In total, 31 articles involving 5,846 participants were included in this study. Among these, 2,938 were identified as patients with PE (664 severe PE, 619 mild PE, and 1,655 undefined PE), while 2,908 were normotensive pregnant mothers. The overall pooled standardized mean difference (SMD) for FIB and DD between PE and normotensive pregnant mothers were 0.26 (95% CI: -0.12-0.64, p = 0.18) and 0.81 (95% CI: 0.43–1.18, p < 0.001), respectively. These findings suggest a significant increase in DD levels among PE patients compared to normotensive pregnant mothers, while the elevation in FIB levels among PE patients did not reach statistical significance. Conclusions These findings highlight the potential utility of DD as a biomarker for identifying and monitoring PE during pregnancy. However, further research is warranted to elucidate the clinical implications and predictive value of DD levels in the context of PE diagnosis and management. Additionally, the non-significant difference in FIB levels highlights the need for continued investigation into the underlying mechanisms and diagnostic relevance of FIB in PE.
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spelling doaj-art-69899f9ef5d4447ca73132e8a38c00cc2025-08-20T04:02:50ZengBMCBMC Pregnancy and Childbirth1471-23932025-08-0125111310.1186/s12884-025-07964-8Fibrinogen and D-dimer protein levels in patients with preeclampsia: a systematic review and meta-analysisErmiyas Alemayehu0Alemu Gedefie1Fasil Getu2Zewudu Mulatie3Muluken Walle4Ousman Mohammed5Getachew Mesfin Bambo6Habtu Debash7Yenealem Solomon8Abdurehman Eshete Mohammed9Hussen Ebrahim10Melaku Ashagrie Belete11Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo UniversityDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo UniversityDepartment of Medical Laboratory Science, College of Medicine and Health Sciences, Jigjiga UniversityDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo UniversityDepartment of Hematology and Immunohematology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of GondarDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo UniversityDepartment of Medical Laboratory Sciences, College of Health Sciences, Mizan-Tepi UniversityDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo UniversityDepartment of Medical Laboratory Science, College of Health Sciences, Debre Tabor UniversityDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo UniversityDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo UniversityDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo UniversityAbstract Introduction Preeclampsia (PE) is a significant obstetric and global health concern associated with fetal growth restriction, poor placental perfusion, and maternal organ dysfunction. Early detection through simple, routine antenatal indicators is essential. This systematic review and meta-analysis assessed fibrinogen (FIB) and D-dimer (DD) levels in PE patients compared to normotensive pregnant women. Methods Relevant articles were systematically identified through comprehensive searches across multiple databases such as PubMed, Scopus, Embase, and Hinari. Utilizing Stata version 14.0, we employed a random-effects model to estimate the pooled standardized mean difference (SMD) along with their corresponding 95% confidence intervals (CIs). Heterogeneity was assessed using I2 statistics and the Cochrane Q test, while subgroup analyses and meta-regression were conducted to investigate potential sources of heterogeneity. Additionally, sensitivity analysis was performed to assess the robustness of the findings. Furthermore, Egger’s regression test and funnel plot were utilized to evaluate publication bias among the included studies. Results In total, 31 articles involving 5,846 participants were included in this study. Among these, 2,938 were identified as patients with PE (664 severe PE, 619 mild PE, and 1,655 undefined PE), while 2,908 were normotensive pregnant mothers. The overall pooled standardized mean difference (SMD) for FIB and DD between PE and normotensive pregnant mothers were 0.26 (95% CI: -0.12-0.64, p = 0.18) and 0.81 (95% CI: 0.43–1.18, p < 0.001), respectively. These findings suggest a significant increase in DD levels among PE patients compared to normotensive pregnant mothers, while the elevation in FIB levels among PE patients did not reach statistical significance. Conclusions These findings highlight the potential utility of DD as a biomarker for identifying and monitoring PE during pregnancy. However, further research is warranted to elucidate the clinical implications and predictive value of DD levels in the context of PE diagnosis and management. Additionally, the non-significant difference in FIB levels highlights the need for continued investigation into the underlying mechanisms and diagnostic relevance of FIB in PE.https://doi.org/10.1186/s12884-025-07964-8Coagulation parametersHemostatic parametersFibrinogenD-dimerPreeclampsiaComplicated pregnancy
spellingShingle Ermiyas Alemayehu
Alemu Gedefie
Fasil Getu
Zewudu Mulatie
Muluken Walle
Ousman Mohammed
Getachew Mesfin Bambo
Habtu Debash
Yenealem Solomon
Abdurehman Eshete Mohammed
Hussen Ebrahim
Melaku Ashagrie Belete
Fibrinogen and D-dimer protein levels in patients with preeclampsia: a systematic review and meta-analysis
BMC Pregnancy and Childbirth
Coagulation parameters
Hemostatic parameters
Fibrinogen
D-dimer
Preeclampsia
Complicated pregnancy
title Fibrinogen and D-dimer protein levels in patients with preeclampsia: a systematic review and meta-analysis
title_full Fibrinogen and D-dimer protein levels in patients with preeclampsia: a systematic review and meta-analysis
title_fullStr Fibrinogen and D-dimer protein levels in patients with preeclampsia: a systematic review and meta-analysis
title_full_unstemmed Fibrinogen and D-dimer protein levels in patients with preeclampsia: a systematic review and meta-analysis
title_short Fibrinogen and D-dimer protein levels in patients with preeclampsia: a systematic review and meta-analysis
title_sort fibrinogen and d dimer protein levels in patients with preeclampsia a systematic review and meta analysis
topic Coagulation parameters
Hemostatic parameters
Fibrinogen
D-dimer
Preeclampsia
Complicated pregnancy
url https://doi.org/10.1186/s12884-025-07964-8
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