MicroRNA
‐210 level as a biomarker for pre‐eclampsia severity: A systematic review and meta‐analysis
Dávid Márai, Isabel Pinto Amorim das Virgens, Ádám Vincze, Mahmoud Obeidat, Péter Hegyi, Mikolt Bakony, Zsófia Réka Erdélyi, Zsolt Melczer, Sándor Valent Abstract
Background
Pre‐eclampsia is a serious pregnancy‐related syndrome lacking accurate prognostic markers. MicroRNA‐210, overexpressed in the circulation of women with pre‐eclampsia, has recently emerged as a promising biomarker.
Objectives
We conducted a systematic review and meta‐analysis to evaluate the relationship between miR‐210 levels and pre‐eclampsia at different degrees of severity.
Search Strategy
The study was prospectively registered on PROSPERO (CRD42024604698) and included a comprehensive systematic search of five databases conducted on November 21, 2024.
Selection Criteria, Data Collection and Analysis
The included studies involved pregnant women with mild or severe pre‐eclampsia compared to normotensive controls, meeting guideline‐based diagnostic criteria and reporting circulating microRNA‐210. Precalculated effect sizes were pooled to obtain a weighted mean and 95% confidence interval (CI) for microRNA‐210‐fold increase. Subgroup analysis assessed pre‐eclampsia severity, using an inverse variance method in random‐effects meta‐analysis models.
Main Results
Our search identified 776 records, of which seven were deemed eligible for analysis. The fold change values, reflecting the increase in microRNA‐210 levels between the control and pre‐eclamptic populations, were 3.33 (CI: 0.69–5.98; I 2 = 93%, CI: 88–96%) in the mild pre‐eclampsia group and 7.23 (CI: 2.27–12.18; I 2 = 98%, CI: 98–99%) in the severe pre‐eclampsia group, indicating a significant effect ( P = 0.01) in the subgroup difference tests. The mean ratio of microRNA‐210‐fold change between the two severity groups was 2.05 (CI: 1.41–2.69; I 2 = 85%, P < 0.01), favoring the severe population.
Conclusion
Elevated microRNA‐210 levels are strongly associated with pre‐eclampsia severity at the time of diagnosis, with a consistent, significant stepwise increase from mild to severe disease. Whether miR‐210 holds predictive value earlier in pregnancy remains to be established in prospective studies with first‐trimester sampling.