Abstract：
Conflicting findings have emerged regarding the levels of high mobility group box 1 (HMGB1) in individuals experiencing adverse pregnancy outcomes. Here we conducted a meta-analysis to assess the association between maternal blood HMGB1 levels and adverse pregnancy outcomes. Utilizing databases such as PubMed, Cochrane Central Register of Controlled Trials, Web of Science, Embase and China National Knowledge Infrastructure (CNKI), a systematic literature search was conducted in January 2024. Eligible literature was screened according to inclusion and exclusion criteria. Quality assessment was evaluated using the Newcastle-Ottawa Scale (NOS). The extracted data were analyzed using Review Manager 5.4 and STATA 12.0 software. 21 observational studies with a total of 2471 participants were included in this meta-analysis. Significantly higher peripheral blood levels of HMGB1 were associated with preeclampsia (PE) (SMD=1.34; 95% CI: 0.72-1.95; P < 0.0001) and gestational diabetes mellitus (GDM) (SMD=1.20; 95% CI: 0.31-2.09; P = 0.009). Additionally, HMGB1 levels in peripheral blood were significantly elevated in patients with unexplained recurrent spontaneous abortion (URSA) than those in pregnancy controls (SMD=4.22; 95% CI: 1.64-6.80; P = 0.001) or non-pregnancy controls (SMD=3.87; 95% CI: 1.81-5.92; P = 0.0002). Interestingly, higher blood HMGB1 levels were observed in women with preterm birth (PTB), however, the results did not reach a statistical difference (SMD=0.54; 95% CI: -0.36-1.44; P = 0.24). In conclusion, overexpressed maternal blood HMGB1 levels were associated with adverse pregnancy outcomes, including PE, GDM and URSA. Further studies should be conducted to validate the efficacy of HMGB1 as a biomarker for assessing the risk of adverse pregnancy outcomes.
摘要：
关于经历不良妊娠结局的个体中高流动性组1（HMGB1）的水平，已经出现了矛盾的发现。在这里，我们进行了一项荟萃分析，以评估孕妇血液HMGB1水平与不良妊娠结局之间的关系。利用PubMed等数据库，Cochrane中央控制试验登记册,WebofScience,Embase与中国国家知识基础设施(CNKI),2024年1月进行了系统的文献检索.根据纳入和排除标准筛选符合条件的文献。使用纽卡斯尔-渥太华量表（NOS）评估质量。使用ReviewManager5.4和STATA12.0软件分析提取的数据。该荟萃分析包括21项观察性研究，共有2471名参与者。外周血HMGB1水平显著升高与子痫前期(PE)(SMD=1.34;95%CI:0.72-1.95;P<0.0001)和妊娠期糖尿病(GDM)(SMD=1.20;95%CI:0.31-2.09;P=0.009)相关。此外,原因不明复发性流产(URSA)患者外周血HMGB1水平明显高于妊娠对照组(SMD=4.22;95%CI:1.64~6.80;P=0.001)或非妊娠对照组(SMD=3.87;95%CI:1.81~5.92;P=0.0002)。有趣的是,在早产（PTB）妇女中观察到较高的血液HMGB1水平，然而,结果没有达到统计学差异(SMD=0.54;95%CI:-0.36-1.44;P=0.24)。总之,高表达的孕妇血HMGB1水平与不良妊娠结局相关,包括PE,GDM和URSA。应进行进一步的研究以验证HMGB1作为评估不良妊娠结局风险的生物标志物的功效。
