Study on risk factors of preeclampsia based on umbrella review and Mendelian randomization

SONG Xiaojie; WU Jing'ou; WANG Zhaoxia

doi:10.12102/j.issn.2095-8668.2025.20.008

Abstract：Objective:To analyze the quality and evidence credibility of Meta-analyses on preeclampsia risk factors using an umbrella review approach.To select risk factors with lower evidence credibility for Mendelian randomization studies,thereby verifying their causal relationship with preeclampsia.Methods:Computerized searches were conducted in PubMed and Web of Science for Meta-analyses on preeclampsia risk factors.The search period spanned from database inception to May 20,2024.Included Meta-analyses underwent quality and evidence credibility assessment using the umbrella evaluation paradigm.The inverse variance weighting method within R software was utilized to validate the causal relationship between periodontal disease,a risk factor with low evidence credibility,and preeclampsia.Results:Twenty-two Meta-analyses were ultimately included.Periodontal disease,classified as low-certainty evidence,was designated as the exposure factor in a Mendelian randomization analysis.The causal effect analysis yielded an odds ratio of 1.12(P<0.05).Sensitivity analysis revealed that the confidence interval for the instrumental variable(single nucleotide polymorphism)did not cross zero.These findings indicate that periodontal disease was an independent risk factor for preeclampsia.Conclusion:Currently,only a limited number of preeclampsia risk factors have moderate-certainty evidence.Individuals with a history of chronic hypertension and a body mass index>30 kg/m² exhibit a significantly increased risk of preeclampsia,while those who tack vitamin D supplements daily show a significantly reduced risk.