Can single progesterone concentration predict miscarriage in early pregnant women with threatened miscarriage: a systematic review and meta-analysis
Abstract Background About 25% of pregnant women experience bleeding in the early stage, and half of them eventually progress to pregnancy loss. Progesterone serves as a useful biomarker to predict miscarriage in threatened miscarriage, yet its performance is still debated. Aim To evaluate the perfor...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-024-06303-7 |
| _version_ | 1827325826868183040 |
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| author | Yi Gong Tong Jiang Yang Sun Guo-Lin Wu Bu-Wei Han Ying Shi Shan Guan Jian Li |
| author_facet | Yi Gong Tong Jiang Yang Sun Guo-Lin Wu Bu-Wei Han Ying Shi Shan Guan Jian Li |
| author_sort | Yi Gong |
| collection | DOAJ |
| description | Abstract Background About 25% of pregnant women experience bleeding in the early stage, and half of them eventually progress to pregnancy loss. Progesterone serves as a useful biomarker to predict miscarriage in threatened miscarriage, yet its performance is still debated. Aim To evaluate the performance of single serum progesterone predicting miscarriage in early pregnant patients with threatened miscarriage. Method The online database was searched to yield the literature using the terms of ‘Abortion’, ‘Miscarriage’, and ‘serum Progesterone’, including PubMed, Scopus, Embase, Cochrane library, and China national knowledge infrastructure. Receiver operating characteristic (ROC) curve, likelihood ratio (LLR) and diagnostic odds ratio (DOR) and 95% confidence interval (CI) were computed. Publication bias was assessed by the deeks funnel plot asymmetry test. Subgroup analyses were conducted according to the progesterone level (< 12 ng/mL), recruited location and region, progesterone measurement method, exogenous progesterone supplement and follow up. Results In total, 12 studies were eligible to be included in this study, with sample sizes ranging from 76 to 1087. The included patients’ gestational age was between 4 and 12 weeks. No significant publication bias was detected from all included studies. The threshold of progesterone reported ranged from 8 to 30 ng/ml. The synthesized area under the ROC curve (0.85, 95% CI 0.81 to 0.88), positive LLR (6.2, 4.0 to 9.7) and DOR (18, 12 to 27) of single progesterone measurement distinguishing miscarriage were relatively good in early pregnant patients with threatened miscarriage. When the threshold of < 12 ng/mL was adapted, the progesterone provided a higher area under the ROC curve (0.90 vs. 0.78), positive LLR (8.3 vs. 3.8) and DOR (22 vs.12) than its counterpart (12 to 30 ng/mL). Conclusion Single progesterone measurement can act as a biomarker of miscarriage in early pregnant patients with threatened miscarriage, and it has a better performance when the concentration is <12 ng/mL. Trial registration PROSPERO (CRD42021255382). |
| first_indexed | 2024-03-07T14:35:58Z |
| format | Article |
| id | doaj.art-7f98f17a07364bab84836344bb8a3afa |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-03-07T14:35:58Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-7f98f17a07364bab84836344bb8a3afa2024-03-05T20:40:18ZengBMCBMC Pregnancy and Childbirth1471-23932024-02-012411910.1186/s12884-024-06303-7Can single progesterone concentration predict miscarriage in early pregnant women with threatened miscarriage: a systematic review and meta-analysisYi Gong0Tong Jiang1Yang Sun2Guo-Lin Wu3Bu-Wei Han4Ying Shi5Shan Guan6Jian Li7Beilun District People’s Hospital, Beilun Branch of the First Affiliated Hospital of Zhejiang UniversityBeilun District People’s Hospital, Beilun Branch of the First Affiliated Hospital of Zhejiang UniversityGuizhou Medical UniversityBeilun District People’s Hospital, Beilun Branch of the First Affiliated Hospital of Zhejiang UniversityCollege of Pharmacy, Harbin University of CommerceBeilun District People’s Hospital, Beilun Branch of the First Affiliated Hospital of Zhejiang UniversityDepartment of Obstetrics & Gynecology, Affiliated Hospital of Guizhou Medical UniversityDepartment of Obstetrics & Gynecology, Affiliated Hospital of Guizhou Medical UniversityAbstract Background About 25% of pregnant women experience bleeding in the early stage, and half of them eventually progress to pregnancy loss. Progesterone serves as a useful biomarker to predict miscarriage in threatened miscarriage, yet its performance is still debated. Aim To evaluate the performance of single serum progesterone predicting miscarriage in early pregnant patients with threatened miscarriage. Method The online database was searched to yield the literature using the terms of ‘Abortion’, ‘Miscarriage’, and ‘serum Progesterone’, including PubMed, Scopus, Embase, Cochrane library, and China national knowledge infrastructure. Receiver operating characteristic (ROC) curve, likelihood ratio (LLR) and diagnostic odds ratio (DOR) and 95% confidence interval (CI) were computed. Publication bias was assessed by the deeks funnel plot asymmetry test. Subgroup analyses were conducted according to the progesterone level (< 12 ng/mL), recruited location and region, progesterone measurement method, exogenous progesterone supplement and follow up. Results In total, 12 studies were eligible to be included in this study, with sample sizes ranging from 76 to 1087. The included patients’ gestational age was between 4 and 12 weeks. No significant publication bias was detected from all included studies. The threshold of progesterone reported ranged from 8 to 30 ng/ml. The synthesized area under the ROC curve (0.85, 95% CI 0.81 to 0.88), positive LLR (6.2, 4.0 to 9.7) and DOR (18, 12 to 27) of single progesterone measurement distinguishing miscarriage were relatively good in early pregnant patients with threatened miscarriage. When the threshold of < 12 ng/mL was adapted, the progesterone provided a higher area under the ROC curve (0.90 vs. 0.78), positive LLR (8.3 vs. 3.8) and DOR (22 vs.12) than its counterpart (12 to 30 ng/mL). Conclusion Single progesterone measurement can act as a biomarker of miscarriage in early pregnant patients with threatened miscarriage, and it has a better performance when the concentration is <12 ng/mL. Trial registration PROSPERO (CRD42021255382).https://doi.org/10.1186/s12884-024-06303-7Threatened miscarriageSerum progesteronePredictionMiscarriageMeta-analysis |
| spellingShingle | Yi Gong Tong Jiang Yang Sun Guo-Lin Wu Bu-Wei Han Ying Shi Shan Guan Jian Li Can single progesterone concentration predict miscarriage in early pregnant women with threatened miscarriage: a systematic review and meta-analysis BMC Pregnancy and Childbirth Threatened miscarriage Serum progesterone Prediction Miscarriage Meta-analysis |
| title | Can single progesterone concentration predict miscarriage in early pregnant women with threatened miscarriage: a systematic review and meta-analysis |
| title_full | Can single progesterone concentration predict miscarriage in early pregnant women with threatened miscarriage: a systematic review and meta-analysis |
| title_fullStr | Can single progesterone concentration predict miscarriage in early pregnant women with threatened miscarriage: a systematic review and meta-analysis |
| title_full_unstemmed | Can single progesterone concentration predict miscarriage in early pregnant women with threatened miscarriage: a systematic review and meta-analysis |
| title_short | Can single progesterone concentration predict miscarriage in early pregnant women with threatened miscarriage: a systematic review and meta-analysis |
| title_sort | can single progesterone concentration predict miscarriage in early pregnant women with threatened miscarriage a systematic review and meta analysis |
| topic | Threatened miscarriage Serum progesterone Prediction Miscarriage Meta-analysis |
| url | https://doi.org/10.1186/s12884-024-06303-7 |
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