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

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.