title: Novel biomarkers for predicting intrauterine growth restriction: a systematic review and meta-analysis.
abstract: BACKGROUND
  Several biomarkers for predicting intrauterine growth restriction (IUGR) have been proposed in recent years. However, the predictive performance of these biomarkers has not been systematically evaluated.
  
  
  OBJECTIVE
  To determine the predictive accuracy of novel biomarkers for IUGR in women with singleton gestations.
  
  
  METHODS
  Electronic databases, reference list checking and conference proceedings.
  
  
  METHODS
  Observational studies that evaluated the accuracy of novel biomarkers proposed for predicting IUGR.
  
  
  METHODS
  Data were extracted on characteristics, quality and predictive accuracy from each study to construct 2×2 tables. Summary receiver operating characteristic curves, sensitivities, specificities and likelihood ratios (LRs) were generated.
  
  
  RESULTS
  A total of 53 studies, including 39,974 women and evaluating 37 novel biomarkers, fulfilled the inclusion criteria. Overall, the predictive accuracy of angiogenic factors for IUGR was minimal (median pooled positive and negative LRs of 1.7, range 1.0-19.8; and 0.8, range 0.0-1.0, respectively). Two small case-control studies reported high predictive values for placental growth factor and angiopoietin-2 only when IUGR was defined as birthweight centile with clinical or pathological evidence of fetal growth restriction. Biomarkers related to endothelial function/oxidative stress, placental protein/hormone, and others such as serum levels of vitamin D, urinary albumin:creatinine ratio, thyroid function tests and metabolomic profile had low predictive accuracy.
  
  
  CONCLUSIONS
  None of the novel biomarkers evaluated in this review are sufficiently accurate to recommend their use as predictors of IUGR in routine clinical practice. However, the use of biomarkers in combination with biophysical parameters and maternal characteristics could be more useful and merits further research.
authors: Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, USA.
authors: A
authors: A
authors: Conde-Agudelo
authors: A T
authors: AT
authors: Papageorghiou
authors: S H
authors: SH
authors: Kennedy
authors: J
authors: J
authors: Villar
mesh_terms: D015415:Biomarkers / Q000032:analysis*; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers