Current Hypertension Reviews   Send Orders for Reprints to reprints@benthamscience.ae Current Hypertension Reviews, 2018, 14, 21-28 21 SYSTEMATIC REVIEW ARTICLE A Systematic Review of First Trimester Biochemical and Molecular Predictive Tests for Preeclampsia Fatemeh Abdi 1 , Zohreh Aghaie 2 , Fatemeh Sadat Rahnemaie 2 and Zainab Alimoradi 3,* 1 Student Research Committee, Nursing and Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2 Nursing and Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3 Social Determi- nants of Health Research Centre (SDH), Qazvin University of Medical Sciences, Qazvin, Iran Abstract: Background: Preeclampsia is a multisystem disorder affecting 5%-8% of pregnant women. Considering the ongoing debate over the predicting value of some commercial first trimes- ter tests, the aim of this study was to compare the existing first-trimester screening tests for preeclampsia. Methods: In this systematic review, relevant articles published during 2000-2017 were extracted from PubMed, Science Direct, Scopus, Cochrane Library, ISI Web of Science, and ProQuest data- bases. After a thorough evaluation of the 412 potentially eligible papers, only 28 papers were se- lected based on the inclusion criteria. Results: From a total of 412 retrieved studies, 28 papers were found eligible. Most studies had case- control or nested case-control designs. A total of 15164 pregnant women were evaluated in the re- viewed studies. Various tests were applied in the first trimester of pregnancy to predict the devel- opment of preeclampsia. The most commonly used biomarkers were uterine artery pulsatility index, pregnancy-associated plasma protein A (PAPP-A), adiponectin, human chorionic gonadotropin (hCG) hormone and inhibin-A. Other tests were used in only one or two studies. Conclusion: Based on this review, a combination of markers should be evaluated for the identifica- tion of high-risk women. Novel methods measuring multiple markers will hopefully facilitate the development of clinically effective screening programs in the future. Keywords: Preeclampsia, screening test, first trimester, screening tests, human Chorionic Gonadotropin (hCG) hormone, inhibin-A. 1. INTRODUCTION Preeclampsia is a condition affecting 5%-8% of pregnant women in second half of gestation. It is characterized by a number of clinical symptoms including high blood pressure including systolic blood pressure equal or more than 140 mmHg or diastolic blood pressure equal or more than 90 mmHg and proteinuria ≥ 0.3 g/24 hours [1]. Preeclampsia is responsible for a great percentage of complications, not only fetal deaths but also maternal morbidity and mortality during pregnancy [2]. Although no definitive treatment has been proposed for preeclampsia, efforts to promote maternal health have resulted in the identification of several reliable biomarkers for the prediction and diagnosis of the condition [3]. In the absence of reliable screening tests for the diagnosis *Address correspondence to this author at the Social Determinants of Health Research Centre (SDH), Qazvin University of Medical Sciences, Qazvin, Iran; Tel: +98- 28- 33336003; E-mails: zainabalimoradi.sbmu.ac.ir@gmail.com; z.alimoradi@qums.ac.ir of preeclampsia at its early stages, combinations of clinical, biochemical, and biophysical markers have been recently found to improve the predictive power of the existing screen- ing tools [4]. Currently, commercially available first trimester tests claim to predict the development of preeclampsia using vari- ous biomarkers, e.g. placental hormones, angiogenic factors, and lipids, or placental perfusion and vascular resistance. However, their clinical utility as well as their potential to adhere to screening principles is still under debate [5, 6]. However, according to recent research, no single method can predict the incidence of preeclampsia in a clinical setting. In fact, the sensitivity and specificity of the existing tests are not high enough for clinical use. Large longitudinal studies are hence essential to determine the efficacy and cost- effectiveness of early prediction methods [7]. Owing to the significant effects of preeclampsia on pregnancy outcomes, a large number of studies have evalu- ated the usefulness of different screening tests. Systematic A R T I C L E H I S T O R Y Received: January 24, 2018 Revised: March 30, 2018 Accepted: April 09, 2018 DOI: 10.2174/1573402114666180416160425 1875-6506/18 $58.00+.00 © 2018 Bentham Science Publishers