Biomarcadores e pré-eclâmpsia: uma revisão integrativa
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Jun 25, 2022
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Resumo
Objetivo: Descrever quais biomarcadores se relacionam com a pré-eclâmpsia grave ou não e quais as principais conclusões a seu respeito. Métodos: Trata-se de um estudo de abordagem qualitativa, por meio de uma revisão integrativa de literatura. As bases de dados utilizadas foram: PubMed, Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS) e Cochrane Library (CL). Para a busca dos artigos nas plataformas foram utilizados os descritores “biochemical markers”, “prediction” e “pre-eclampsia”. Resultados: Após a aplicação de critérios de inclusão e exclusão, foram selecionados 23 artigos. Dentre os resultados, destacaram-se o fator de crescimento placentário (PlFG) e a tirosina quinase-1 solúvel semelhante a fms (sFlt-1), os quais são apontados como tendo uma promissora utilização no rastreio e predição de casos de PE. Considerações finais: Acredita-se que o PlGF e a sFlt-1, e sua correlação (PlGF/sFtl-1), associem-se fidedignamente mais à estratificação para o risco de PE, bem como à previsão do parto.
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IostA. R. J., MoraesM. de S., GoulartT. de L., SilvaC. M. A. e, FerreiraV. L., OtteroC. de L. S., & Figueiredo JúniorH. S. de. (2022). Biomarcadores e pré-eclâmpsia: uma revisão integrativa. Revista Eletrônica Acervo Médico, 11, e10389. https://doi.org/10.25248/reamed.e10389.2022
Seção
Revisão Bibliográfica
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Referências
1. BLANKLEY RT, et al. A label-free selected reaction monitoring workflow identifies a subset of pregnancy specific glycoproteins as potential predictive markers of early-onset pre-eclampsia. Mol Cell Proteomics, 2013; 12(11): 3148-59.
2. BOUCOIRAN I, et al. Risks for preeclampsia and small for gestational age: predictive values of placental growth factor, soluble fms-like tyrosine kinase-1, and inhibin A in singleton and multiple-gestation pregnancies. Am J Perinatol., 2013; 30(7): 607-12.
3. BRASIL. Secretária do Estado da Saúde, Governo de Santa Catarina. A pré-eclâmpsia afeta até 7% das brasileiras. 2019. Disponível em: https://www.saude.sc.gov.br/index.php/noticias-geral/todas-as-noticias/1641-noticias-2019/10661-a-pre-eclampsia-afeta-ate-7-das-brasileiras#:~:text=Quase%2076%20mil%20m%C3%A3es%20e,e%207%25%20das%20gr%C3%A1vidas%20brasileiras. Acessado em: 13 de jan de 2022.
4. CERDEIRA AS, et al. Randomized Interventional Study on Prediction of Preeclampsia/Eclampsia in Women With Suspected Preeclampsia: INSPIRE. Hypertension, 2019; 74(4): 983-990.
5. DE VIVO A, et al. Endoglin, PlGF and sFlt-1 as markers for predicting pre-eclampsia. Acta Obstet Gynecol Scand., 2008; 87(8): 837-42.
6. DELIĆ R, et al. Statistical regression model of standard and new laboratory markers and its usefulness in prediction of preeclampsia. J Matern Fetal Neonatal Med., 2014; 27(4): 388-92.
7. DUNDAR O, et al. Longitudinal study of platelet size changes in gestation and predictive power of elevated MPV in development of preeclampsia. Prenat Diagn., 2008; 28: 1052–6.
8. FARINA A, et al. Prospective evaluation of ultrasound and biochemical-based multivariable models for the prediction of late pre-eclampsia. Prenat Diagn., 2011; 31(12): 1147-52.
9. GAMMILL HS, et al. Does C-reactive protein predict recurrent preeclampsia? Hypertens Pregnancy, 2010; 29(4): 399-409.
10. HAYES-RYAN D, et al. Placental growth factor in assessment of women with suspected pre-eclampsia to reduce maternal morbidity: a stepped wedge cluster randomised control trial (PARROT Ireland). BMJ, 2021; 374: 1857.
11. KARUMANCHI SA, GRANGER JP. Preeclampsia and Pregnancy-Related Hypertensive Disorders. Hypertension, 2016; 67(2): 238-42.
12. KASHANIAN M, et al. Evaluation of the diagnostic value of the first-trimester maternal serum high-sensitivity C-reactive protein level for prediction of pre-eclampsia. J Obstet Gynaecol Res., 2013; 39(12): 1549-54.
13. KUMARI M, et al. Circulating NT-proBNP but not soluble corin levels were associated with preeclampsia in pregnancy-associated hypertension. Clin Biochem., 2019; 67: 12-15.
14. MEIRI H, et al. Prediction of preeclampsia by placental protein 13 and background risk factors and its prevention by aspirin. J Perinat Med., 2014; 42(5): 591-601.
15. MOORE SIMAS TA, et al. Angiogenic factors for the prediction of preeclampsia in high-risk women. Am J Obstet Gynecol., 2007; 197(3): 244-8.
16. MULLER F, et al. Maternal serum human chorionic gonadotropin level at fifteen weeks is a predictor for preeclampsia. Am J Obstet Gynecol., 1996; 175: 37-40.
17. MURTONIEMI K, et al. Prediction of pre-eclampsia and its subtypes in high-risk cohort: hyperglycosylated human chorionic gonadotropin in multivariate models. BMC Pregnancy Childbirth., 2018; 18(1): 279.
18. MYATT L, et al. Can changes in angiogenic biomarkers between the first and second trimesters of pregnancy predict development of pre-eclampsia in a low-risk nulliparous patient population?. BJOG, 2013; 120(10): 1183-91.
19. MYERS JE, et al. Angiogenic factors combined with clinical risk factors to predict preterm pre-eclampsia in nulliparous women: a predictive test accuracy study. BJOG, 2013; 120(10): 1215-23.
20. OZAT M, et al. Serum concentrations of CA-125 in normal and preeclamptic pregnancies. Arch Gynecol Obstet., 2011; 284(3): 607-12.
21. PERRY H, et al. Angiogenic Marker Prognostic Models in Pregnant Women With Hypertension. Hypertension, 2020; 75(3): 755-761.
22. PHIPPS EA, et al. Pre-eclampsia: pathogenesis, novel diagnostics and therapies. Nat Rev Nephrol. 2019;15(5):275-289.
23. POON LC, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet., 2019; 145: 1-33.
24. RANA S, et al. Angiogenic factors and the risk of adverse outcomes in women with suspected preeclampsia. Circulation, 2012; 125(7): 911-9.
25. SCHOOFS K, et al. The importance of repeated measurements of the sFlt-1/PlGF ratio for the prediction of preeclampsia and intrauterine growth restriction. J Perinat Med., 2014; 42(1): 61-8.
26. SHU C, et al. Protein profiling of preeclampsia placental tissues. PLoS One, 2014; 9(11): 112.
27. SIBAI BM, et al. Serum inhibin A and angiogenic factor levels in pregnancies with previous preeclampsia and/or chronic hypertension: are they useful markers for prediction of subsequent preeclampsia? Am J Obstet Gynecol., 2008; 199(3): 268.
28. STAMILIO DM, et al. Can antenatal clinical and biochemical markers predict the development of severe preeclampsia? Am J Obstet Gynecol., 2000; 182(3): 589-94.
29. YANG SW, et al. Significance of the platelet distribution width as a severity marker for the development of preeclampsia. Eur J Obstet Gynecol Reprod Biol., 2014; 175: 107-11.
30. YOUSSEF A, et al. Uterine artery Doppler and biochemical markers (PAPP-A, PIGF, sFlt-1, P-selectin, NGAL) at 11 + 0 to 13 + 6 weeks in the prediction of late (> 34 weeks) pre-eclampsia. Prenat Diagn., 2011; 31(12): 1141-6.
31. ZEISLER H, et al. Predictive value of the sFlt-1: PlGF ratio in women with suspected preeclampsia. N Engl J Med., 2016; 374: 13–22.
2. BOUCOIRAN I, et al. Risks for preeclampsia and small for gestational age: predictive values of placental growth factor, soluble fms-like tyrosine kinase-1, and inhibin A in singleton and multiple-gestation pregnancies. Am J Perinatol., 2013; 30(7): 607-12.
3. BRASIL. Secretária do Estado da Saúde, Governo de Santa Catarina. A pré-eclâmpsia afeta até 7% das brasileiras. 2019. Disponível em: https://www.saude.sc.gov.br/index.php/noticias-geral/todas-as-noticias/1641-noticias-2019/10661-a-pre-eclampsia-afeta-ate-7-das-brasileiras#:~:text=Quase%2076%20mil%20m%C3%A3es%20e,e%207%25%20das%20gr%C3%A1vidas%20brasileiras. Acessado em: 13 de jan de 2022.
4. CERDEIRA AS, et al. Randomized Interventional Study on Prediction of Preeclampsia/Eclampsia in Women With Suspected Preeclampsia: INSPIRE. Hypertension, 2019; 74(4): 983-990.
5. DE VIVO A, et al. Endoglin, PlGF and sFlt-1 as markers for predicting pre-eclampsia. Acta Obstet Gynecol Scand., 2008; 87(8): 837-42.
6. DELIĆ R, et al. Statistical regression model of standard and new laboratory markers and its usefulness in prediction of preeclampsia. J Matern Fetal Neonatal Med., 2014; 27(4): 388-92.
7. DUNDAR O, et al. Longitudinal study of platelet size changes in gestation and predictive power of elevated MPV in development of preeclampsia. Prenat Diagn., 2008; 28: 1052–6.
8. FARINA A, et al. Prospective evaluation of ultrasound and biochemical-based multivariable models for the prediction of late pre-eclampsia. Prenat Diagn., 2011; 31(12): 1147-52.
9. GAMMILL HS, et al. Does C-reactive protein predict recurrent preeclampsia? Hypertens Pregnancy, 2010; 29(4): 399-409.
10. HAYES-RYAN D, et al. Placental growth factor in assessment of women with suspected pre-eclampsia to reduce maternal morbidity: a stepped wedge cluster randomised control trial (PARROT Ireland). BMJ, 2021; 374: 1857.
11. KARUMANCHI SA, GRANGER JP. Preeclampsia and Pregnancy-Related Hypertensive Disorders. Hypertension, 2016; 67(2): 238-42.
12. KASHANIAN M, et al. Evaluation of the diagnostic value of the first-trimester maternal serum high-sensitivity C-reactive protein level for prediction of pre-eclampsia. J Obstet Gynaecol Res., 2013; 39(12): 1549-54.
13. KUMARI M, et al. Circulating NT-proBNP but not soluble corin levels were associated with preeclampsia in pregnancy-associated hypertension. Clin Biochem., 2019; 67: 12-15.
14. MEIRI H, et al. Prediction of preeclampsia by placental protein 13 and background risk factors and its prevention by aspirin. J Perinat Med., 2014; 42(5): 591-601.
15. MOORE SIMAS TA, et al. Angiogenic factors for the prediction of preeclampsia in high-risk women. Am J Obstet Gynecol., 2007; 197(3): 244-8.
16. MULLER F, et al. Maternal serum human chorionic gonadotropin level at fifteen weeks is a predictor for preeclampsia. Am J Obstet Gynecol., 1996; 175: 37-40.
17. MURTONIEMI K, et al. Prediction of pre-eclampsia and its subtypes in high-risk cohort: hyperglycosylated human chorionic gonadotropin in multivariate models. BMC Pregnancy Childbirth., 2018; 18(1): 279.
18. MYATT L, et al. Can changes in angiogenic biomarkers between the first and second trimesters of pregnancy predict development of pre-eclampsia in a low-risk nulliparous patient population?. BJOG, 2013; 120(10): 1183-91.
19. MYERS JE, et al. Angiogenic factors combined with clinical risk factors to predict preterm pre-eclampsia in nulliparous women: a predictive test accuracy study. BJOG, 2013; 120(10): 1215-23.
20. OZAT M, et al. Serum concentrations of CA-125 in normal and preeclamptic pregnancies. Arch Gynecol Obstet., 2011; 284(3): 607-12.
21. PERRY H, et al. Angiogenic Marker Prognostic Models in Pregnant Women With Hypertension. Hypertension, 2020; 75(3): 755-761.
22. PHIPPS EA, et al. Pre-eclampsia: pathogenesis, novel diagnostics and therapies. Nat Rev Nephrol. 2019;15(5):275-289.
23. POON LC, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet., 2019; 145: 1-33.
24. RANA S, et al. Angiogenic factors and the risk of adverse outcomes in women with suspected preeclampsia. Circulation, 2012; 125(7): 911-9.
25. SCHOOFS K, et al. The importance of repeated measurements of the sFlt-1/PlGF ratio for the prediction of preeclampsia and intrauterine growth restriction. J Perinat Med., 2014; 42(1): 61-8.
26. SHU C, et al. Protein profiling of preeclampsia placental tissues. PLoS One, 2014; 9(11): 112.
27. SIBAI BM, et al. Serum inhibin A and angiogenic factor levels in pregnancies with previous preeclampsia and/or chronic hypertension: are they useful markers for prediction of subsequent preeclampsia? Am J Obstet Gynecol., 2008; 199(3): 268.
28. STAMILIO DM, et al. Can antenatal clinical and biochemical markers predict the development of severe preeclampsia? Am J Obstet Gynecol., 2000; 182(3): 589-94.
29. YANG SW, et al. Significance of the platelet distribution width as a severity marker for the development of preeclampsia. Eur J Obstet Gynecol Reprod Biol., 2014; 175: 107-11.
30. YOUSSEF A, et al. Uterine artery Doppler and biochemical markers (PAPP-A, PIGF, sFlt-1, P-selectin, NGAL) at 11 + 0 to 13 + 6 weeks in the prediction of late (> 34 weeks) pre-eclampsia. Prenat Diagn., 2011; 31(12): 1141-6.
31. ZEISLER H, et al. Predictive value of the sFlt-1: PlGF ratio in women with suspected preeclampsia. N Engl J Med., 2016; 374: 13–22.