Regulatory T Cells in Pregnancy Adverse Outcomes: A Systematic Review and Meta-Analysis

作者：Samantha Green, Marina Politis, Kathrine S Rallis, Alba Sáenz de Villaverde Cortabarría, Athina Efthymiou, Nicoleta Mureanu, Kathryn V. Dalrymple, Cristiano Scottà, Giovanna Lombardi, Rachel M. Tribe, K. H. Nicolaides, Panicos Shangaris · 发表于：Frontiers in Immunology · 年份：2021 · 被引用次数：47 · 研究领域：Reproductive System and Pregnancy、Pregnancy and preeclampsia studies、Pregnancy and Medication Impact

Background Several studies report the role of Regulatory T-cells (Tregs) in the pathophysiology of pregnancy adverse outcomes. Objective The aim of this systematic review and meta-analysis was to determine whether there is an association between regulatory T cell levels and pregnancy adverse outcomes (PAOs), including pre-eclampsia and preterm birth (PTB). Method Literature searches were conducted in PubMed/MEDLINE, Embase, and Cochrane CENTRAL databases. Inclusion criteria were original articles (clinical trials, case-control studies and cohort studies) comparing Tregs, sampled from the decidua or maternal blood, in healthy pregnant women versus women with pre-eclampsia or PTB. The outcome was standardised mean difference (SMD) in Treg numbers. The tau-squared (Tau²), inconsistency index (I²), and chi-squared (χ²) test quantified heterogeneity among different studies. Analyses were performed in RevMan software V.5.4.0 for Mac using a random-effects model with outcome data reported with 95% confidence intervals (CI). This study was prospectively registered with PROSPERO (CRD42020205469). PRISMA guidelines were followed. Results From 4,085 unique studies identified, 36 were included in qualitative synthesis, and 34 were included in quantitative synthesis (meta-analysis). In total, there were 1,783 participants in these studies: healthy controls=964, pre-eclampsia=759, PTB=60. Thirty-two studies compared Tregs in healthy pregnant women and women with pre-eclampsia, and 30 of th...