PhD Scientific Days 2024

Poster Session O - Surgical Medicine

Meta-Analysis on Predictive Markers and Preventive Measures for Preeclampsia: A Comprehensive Review

Text of the abstract

Introduction:
Preeclampsia, a hypertensive disorder of pregnancy, poses significant risks to both maternal and fetal health. Early screening and treatment are crucial as they can mitigate severe complications such as eclampsia, maternal organ damage, preterm birth, and fetal growth restriction. Timely intervention improves outcomes, highlighting the critical importance of early detection and management in reducing morbidity and mortality rates for both mother and baby.

Aims:
This meta-analysis aims to assess the predictive value of first-trimester neutrophil-to-lymphocyte ratio (NLR) and the efficacy of pravastatin for prophylaxis and treatment of preeclampsia.

Method:
For the assessment of NLR's predictive role, a systematic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, and Embase databases up to December 31, 2022. Studies measuring NLR in the first trimester among patients who later developed preeclampsia were included. PRISMA and MOOSE guidelines were followed, and statistical analyses were conducted using R.

Results:
Six studies encompassing 2,469 patients were included in the meta-analysis for NLR. The analysis revealed a 95% confidence interval (CI) for the effect size of 0.641 to 1.523, with a prediction interval of 0.027 to 2.137, indicating NLR as a promising biochemical marker for first-trimester preeclampsia prediction.
Additionally, a systematic review identified fourteen studies evaluating pravastatin for preeclampsia treatment and/or prophylaxis. Among them, five studies were selected for meta-analysis, showing a 61% reduction in preeclampsia incidence and a 45% reduction in premature birth with pravastatin use. Furthermore, there was a 45% decrease in intrauterine growth retardation (IUGR) and a 77% reduction in neonatal intensive care unit (NICU) admissions among newborns.

Conclusion:
Both NLR and pravastatin show promise in the prediction and prevention of preeclampsia. NLR can serve as a valuable marker in screening protocols for early detection of preeclampsia, while pravastatin demonstrates efficacy in reducing the incidence of preeclampsia and associated adverse outcomes. Further research is encouraged to explore the combined predictive value of NLR with other markers and the long-term safety and efficacy of pravastatin in preeclampsia management.