Evidence map›Paper›PMID 27094586›Full record

SynthesisBMJ (Clinical research ed.)2016

Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies.

Emily Bartsch, Karyn E Medcalf, Alison L Park, Joel G Ray, High Risk of Pre-eclampsia Identification Group

3 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 412 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
412citing papers in PubMed, 14 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04855513 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Prevention of Pre-eclampsia Using Metformin: a Randomized Control Trial

TypeinterventionalSponsorHamad Medical CorporationRan2022 to 2023Enrolled414ConditionsPreeclampsia, Preeclampsia Severe, High Risk Pregnancy, EclampsiaArmsMetformin
NCT05091827 unknown statusnot on this mapstarted 2021, after this paper: background citation

Assessment of the Cardiovascular Risk Profile of Infants Exposed to Pre-eclampsia in Utero

TypeobservationalSponsorWalter Sisulu UniversityRan2021 to 2023Enrolled234ConditionsOffspring of Pre-eclamptic Mothers
NCT07263490 recruitingnot on this mapstarted 2024, after this paper: background citation

PRIOR Study (Pre-eclampsia Risk In Oocyte Recipients) - Investigating Matching, Biomarkers and Outcomes.

TypeobservationalSponsorCopenhagen University Hospital, HvidovreRan2024 to 2028Enrolled462ConditionsPre-eclampsia, Oocyte Donation, Pre-Eclampsia, Complicating Pregnancy
3 · Its place in the literature

Who cites it

412 citing papers in PubMed, 14 syntheses or guidelines pooled it.

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  5. Sedentary behavior during pregnancy and risk of pre-eclampsia and/or gestational hypertension: A systematic review.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025
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352 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Emily BartschUniversity of Toronto, Toronto, Canada.
Karyn E MedcalfUniversity of Toronto, Toronto, Canada.
Alison L ParkInstitute for Clinical Evaluative Sciences, Toronto, Canada.
Joel G RayDepartments of Medicine, Health Policy Management and Evaluation, and Obstetrics and Gynecology, St Michael's Hospital, University of Toronto, Toronto, Canada rayj@smh.ca.
High Risk of Pre-eclampsia Identification Group

Funding

Canadian Institutes of Health Research
6 · The paper itself

Abstract

objectiveTo develop a practical evidence based list of clinical risk factors that can be assessed by a clinician at ≤ 16 weeks' gestation to estimate a woman's risk of pre-eclampsia.

designSystematic review and meta-analysis of cohort studies. DATA SOURCES: PubMed and Embase databases, 2000-15. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Cohort studies with ≥ 1000 participants that evaluated the risk of pre-eclampsia in relation to a common and generally accepted clinical risk factor assessed at ≤ 16 weeks' gestation. DATA EXTRACTION: Two independent reviewers extracted data from included studies. A pooled event rate and pooled relative risk for pre-eclampsia were calculated for each of 14 risk factors.

resultsThere were 25,356,688 pregnancies among 92 studies. The pooled relative risk for each risk factor significantly exceeded 1.0, except for prior intrauterine growth restriction. Women with antiphospholipid antibody syndrome had the highest pooled rate of pre-eclampsia (17.3%, 95% confidence interval 6.8% to 31.4%). Those with prior pre-eclampsia had the greatest pooled relative risk (8.4, 7.1 to 9.9). Chronic hypertension ranked second, both in terms of its pooled rate (16.0%, 12.6% to 19.7%) and pooled relative risk (5.1, 4.0 to 6.5) of pre-eclampsia. Pregestational diabetes (pooled rate 11.0%, 8.4% to 13.8%; pooled relative risk 3.7, 3.1 to 4.3), prepregnancy body mass index (BMI) >30 (7.1%, 6.1% to 8.2%; 2.8, 2.6 to 3.1), and use of assisted reproductive technology (6.2%, 4.7% to 7.9%; 1.8, 1.6 to 2.1) were other prominent risk factors.

conclusionsThere are several practical clinical risk factors that, either alone or in combination, might identify women in early pregnancy who are at "high risk" of pre-eclampsia. These data can inform the generation of a clinical prediction model for pre-eclampsia and the use of aspirin prophylaxis in pregnancy.

Indexed as

AspirinBody Mass IndexChronic DiseaseCohort StudiesEarly DiagnosisFemaleHumansHypertension, Pregnancy-InducedPlatelet Aggregation InhibitorsPre-EclampsiaPregnancyPregnancy in DiabeticsPregnancy Trimester, FirstPregnancy Trimester, SecondPrenatal DiagnosisRandomized Controlled Trials as TopicAspirinPlatelet Aggregation Inhibitors

Identifiers

PMID27094586
PMCPMC4837230

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.