Key points are not available for this paper at this time.
Context: Placenta accreta spectrum (PAS) is an abnormal pregnancy condition that contributes significantly to maternal mortality and morbidity. Approximately 50-67% of PAS cases are undiagnosed before delivery. Therefore, there is an urgent need to find biomarkers that can be used for early detection so that PAS interventions can be provided promptly to reduce maternal mortality. Aims: To evaluate the diagnostic accuracy of microRNAs (miRNAs) as biomarkers of PAS. Methods: A literature search was conducted based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). The search was conducted on several databases, including PubMed and ScienceDirect. The risk of bias in the included articles was assessed based on the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. A random-effects model was used to calculate sensitivity, specificity, positive-likelihood ratio (PLR), negative-likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC). The subgroup analysis was carried out to investigate the heterogeneity. Deeks' funnel plot and Fagan's nomogram were used to evaluate the publication bias clinical application of miRNAs as a PAS diagnostic biomarker, respectively. Results: Based on three included studies involving 165 PAS cases, the pooled sensitivity, specificity, PLR, NLR, DOR, AUC were 0.90 (95% CI: 0.82-0.95), 0.85 (95% CI: 0.79-0.89), 7.24 (95% CI: 5.42-9.06), 0.33 (95% CI: 0.20-0.46), 72.06 (95% CI: 49.27-94.85), and 0.92 (95% CI: 0.90-0.94). Subgroup analysis showed that using cluster and upregulated miRNA enhances the diagnostic power of miRNA. There is no publication bias in this study (p=0.52). Conclusions: This study highlights the superior diagnostic accuracy of miRNAs in diagnosing PAS, indicating their potential as valuable biomarkers for detecting PAS.
Birru et al. (Thu,) studied this question.