American journal of obstetrics & gynecology MFM · 2025
The diagnostic role of miRNAs in identifying placenta Accreta: a systematic review.
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Haddadi Mohammad, Safari Roxana, Hantoushzadeh Sedigheh
Аннотация
OBJECTIVE: This systematic review evaluates the diagnostic accuracy of circulating microRNAs (miRNAs) as potential biomarkers for detecting placenta accreta spectrum (PAS) disorders, a condition characterized by abnormal placental adherence with significant maternal health risks.
DATA SOURCES: A comprehensive literature search was conducted in PubMed, Embase, and Scopus databases up to October 30, 2024, using predefined keywords such as "miRNA" and "placenta accreta."
STUDY ELIGIBILITY: Studies investigating miRNA expression in PAS cases compared to controls, using either blood or placental tissue, were included. Articles were screened independently by 2 reviewers, with discrepancies resolved by consensus.
STUDY APPRAISAL AND SYNTHESIS METHODS: The methodological quality of eligible studies was assessed using the Newcastle-Ottawa Scale. Extracted data were synthesized to identify miRNAs with diagnostic potential for PAS disorders. Due to significant variations in the comparisons conducted across studies and the diverse outcome measures reported, a meta-analysis of the included studies was not feasible.
RESULTS: Out of 82 articles identified, 14 met the inclusion criteria after duplicate removal and screening. The studies reported distinct differential expression patterns of miRNAs in PAS cases. Notably, a combination of miR-26a-5p and miR-17-5p demonstrated 100% sensitivity and 82% specificity for predicting PAS in the first-trimester of pregnancy.
CONCLUSIONS: PAS disorders are typically diagnosed during the third trimester through imaging techniques like ultrasonography. However, miRNAs exhibit promise as non-invasive, early biomarkers, potentially enabling earlier diagnosis and improved clinical management. These findings support the incorporation of miRNA analysis into diagnostic guidelines for PAS.
DATA SOURCES: A comprehensive literature search was conducted in PubMed, Embase, and Scopus databases up to October 30, 2024, using predefined keywords such as "miRNA" and "placenta accreta."
STUDY ELIGIBILITY: Studies investigating miRNA expression in PAS cases compared to controls, using either blood or placental tissue, were included. Articles were screened independently by 2 reviewers, with discrepancies resolved by consensus.
STUDY APPRAISAL AND SYNTHESIS METHODS: The methodological quality of eligible studies was assessed using the Newcastle-Ottawa Scale. Extracted data were synthesized to identify miRNAs with diagnostic potential for PAS disorders. Due to significant variations in the comparisons conducted across studies and the diverse outcome measures reported, a meta-analysis of the included studies was not feasible.
RESULTS: Out of 82 articles identified, 14 met the inclusion criteria after duplicate removal and screening. The studies reported distinct differential expression patterns of miRNAs in PAS cases. Notably, a combination of miR-26a-5p and miR-17-5p demonstrated 100% sensitivity and 82% specificity for predicting PAS in the first-trimester of pregnancy.
CONCLUSIONS: PAS disorders are typically diagnosed during the third trimester through imaging techniques like ultrasonography. However, miRNAs exhibit promise as non-invasive, early biomarkers, potentially enabling earlier diagnosis and improved clinical management. These findings support the incorporation of miRNA analysis into diagnostic guidelines for PAS.