Investigating the association of albuminuria with the incidence of preeclampsia and its predictive capabilities: a systematic review and meta-analysis
Abstract Background Preeclampsia (PE) is a severe hypertensive disorder affecting approximately 6.7% of pregnancies worldwide. Identifying reliable biomarkers for early prediction could significantly reduce the incidence of PE and facilitate closer monitoring and timely management. This study aims t...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-03-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-025-07444-z |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850281549875904512 |
|---|---|
| author | Pegah Rashidian Mohammadamin Parsaei Sedigheh Hantoushzadeh Bahram Salmanian |
| author_facet | Pegah Rashidian Mohammadamin Parsaei Sedigheh Hantoushzadeh Bahram Salmanian |
| author_sort | Pegah Rashidian |
| collection | DOAJ |
| description | Abstract Background Preeclampsia (PE) is a severe hypertensive disorder affecting approximately 6.7% of pregnancies worldwide. Identifying reliable biomarkers for early prediction could significantly reduce the incidence of PE and facilitate closer monitoring and timely management. This study aims to investigate the association between albuminuria in early pregnancy and the subsequent development of PE, and to explore its predictive abilities. Methods A systematic search was conducted across PubMed, Embase, and Web of Science on July 15, 2024, for studies published between January 1, 1990, and June 30, 2024. Quality assessments were performed using the Joanna Briggs Institute Critical Appraisal and Risk of Bias in Non-randomized Studies - of Exposures Checklists. Random-effects models in STATA were used to conduct meta-analyses comparing urine albumin and albumin-to-creatinine ratio levels in patients who later developed PE versus those who did not. The incidence of PE was also compared between patients with and without albuminuria in early pregnancy. The predictive ability of albuminuria for PE was assessed using META-DISC software. Results A total of 26 studies comprising 7,640 pregnant women were systematically reviewed. Of these, 17 studies met the quality criteria for inclusion in the meta-analyses. Our findings indicate that urine albumin (Hedges’s g = 0.48 [95% confidence interval (CI): 0.16–0.80]; p-value < 0.001) and albumin-to-creatinine ratio (Hedges’s g = 0.48 [95% CI: 0.16–0.80]; p-value = 0.003) were significantly higher in the early stages of pregnancy in patients who later developed PE compared to those who did not. The incidence of PE was higher in patients with early-diagnosed albuminuria (log odds ratio = 2.56 [95% CI: 1.75–3.38]; p-value < 0.001). The pooled sensitivity and specificity for albuminuria in predicting PE were 56% [95% CI: 48-64%] and 87% [95% CI: 85-89%], respectively. Conclusions Elevated maternal urine albumin and albumin-to-creatinine ratio in early pregnancy are associated with a higher risk of developing PE. While these biomarkers show promise for early identification of at-risk patients, the relatively low sensitivity suggests that albuminuria alone may not be a robust predictor of PE, which underscores the need for future research in this regard. Trial registration Review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the code CRD42024575772. |
| format | Article |
| id | doaj-art-d3482c83fb804f368adbb1cedc4e1174 |
| institution | OA Journals |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-d3482c83fb804f368adbb1cedc4e11742025-08-20T01:48:15ZengBMCBMC Pregnancy and Childbirth1471-23932025-03-0125111710.1186/s12884-025-07444-zInvestigating the association of albuminuria with the incidence of preeclampsia and its predictive capabilities: a systematic review and meta-analysisPegah Rashidian0Mohammadamin Parsaei1Sedigheh Hantoushzadeh2Bahram Salmanian3Vali-e-Asr Reproductive Health Research Center, Family Research Institute, Tehran University of Medical SciencesBreastfeeding Research Center, Family Research Institute, Tehran University of Medical SciencesVali-e-Asr Reproductive Health Research Center, Family Research Institute, Tehran University of Medical SciencesDepartment of Obstetrics and Gynecology, University of Colorado Health Anschutz Medical CampusAbstract Background Preeclampsia (PE) is a severe hypertensive disorder affecting approximately 6.7% of pregnancies worldwide. Identifying reliable biomarkers for early prediction could significantly reduce the incidence of PE and facilitate closer monitoring and timely management. This study aims to investigate the association between albuminuria in early pregnancy and the subsequent development of PE, and to explore its predictive abilities. Methods A systematic search was conducted across PubMed, Embase, and Web of Science on July 15, 2024, for studies published between January 1, 1990, and June 30, 2024. Quality assessments were performed using the Joanna Briggs Institute Critical Appraisal and Risk of Bias in Non-randomized Studies - of Exposures Checklists. Random-effects models in STATA were used to conduct meta-analyses comparing urine albumin and albumin-to-creatinine ratio levels in patients who later developed PE versus those who did not. The incidence of PE was also compared between patients with and without albuminuria in early pregnancy. The predictive ability of albuminuria for PE was assessed using META-DISC software. Results A total of 26 studies comprising 7,640 pregnant women were systematically reviewed. Of these, 17 studies met the quality criteria for inclusion in the meta-analyses. Our findings indicate that urine albumin (Hedges’s g = 0.48 [95% confidence interval (CI): 0.16–0.80]; p-value < 0.001) and albumin-to-creatinine ratio (Hedges’s g = 0.48 [95% CI: 0.16–0.80]; p-value = 0.003) were significantly higher in the early stages of pregnancy in patients who later developed PE compared to those who did not. The incidence of PE was higher in patients with early-diagnosed albuminuria (log odds ratio = 2.56 [95% CI: 1.75–3.38]; p-value < 0.001). The pooled sensitivity and specificity for albuminuria in predicting PE were 56% [95% CI: 48-64%] and 87% [95% CI: 85-89%], respectively. Conclusions Elevated maternal urine albumin and albumin-to-creatinine ratio in early pregnancy are associated with a higher risk of developing PE. While these biomarkers show promise for early identification of at-risk patients, the relatively low sensitivity suggests that albuminuria alone may not be a robust predictor of PE, which underscores the need for future research in this regard. Trial registration Review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the code CRD42024575772.https://doi.org/10.1186/s12884-025-07444-zAlbuminuriaPredictionPreeclampsiaPregnancyUrine analysis |
| spellingShingle | Pegah Rashidian Mohammadamin Parsaei Sedigheh Hantoushzadeh Bahram Salmanian Investigating the association of albuminuria with the incidence of preeclampsia and its predictive capabilities: a systematic review and meta-analysis BMC Pregnancy and Childbirth Albuminuria Prediction Preeclampsia Pregnancy Urine analysis |
| title | Investigating the association of albuminuria with the incidence of preeclampsia and its predictive capabilities: a systematic review and meta-analysis |
| title_full | Investigating the association of albuminuria with the incidence of preeclampsia and its predictive capabilities: a systematic review and meta-analysis |
| title_fullStr | Investigating the association of albuminuria with the incidence of preeclampsia and its predictive capabilities: a systematic review and meta-analysis |
| title_full_unstemmed | Investigating the association of albuminuria with the incidence of preeclampsia and its predictive capabilities: a systematic review and meta-analysis |
| title_short | Investigating the association of albuminuria with the incidence of preeclampsia and its predictive capabilities: a systematic review and meta-analysis |
| title_sort | investigating the association of albuminuria with the incidence of preeclampsia and its predictive capabilities a systematic review and meta analysis |
| topic | Albuminuria Prediction Preeclampsia Pregnancy Urine analysis |
| url | https://doi.org/10.1186/s12884-025-07444-z |
| work_keys_str_mv | AT pegahrashidian investigatingtheassociationofalbuminuriawiththeincidenceofpreeclampsiaanditspredictivecapabilitiesasystematicreviewandmetaanalysis AT mohammadaminparsaei investigatingtheassociationofalbuminuriawiththeincidenceofpreeclampsiaanditspredictivecapabilitiesasystematicreviewandmetaanalysis AT sedighehhantoushzadeh investigatingtheassociationofalbuminuriawiththeincidenceofpreeclampsiaanditspredictivecapabilitiesasystematicreviewandmetaanalysis AT bahramsalmanian investigatingtheassociationofalbuminuriawiththeincidenceofpreeclampsiaanditspredictivecapabilitiesasystematicreviewandmetaanalysis |