{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T08:07:17Z","timestamp":1789373237531,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"S4","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","award":["MR\/P027938\/1"],"award-info":[{"award-number":["MR\/P027938\/1"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pre\u2010eclampsia is a leading cause of maternal and perinatal morbidity and mortality. There are several determinants of individual pregnant women's risk of developing pre\u2010eclampsia, including biomarkers and ultrasound markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>A conceptual framework to collate and summarise the extensive body of literature on biomarkers (including ultrasound markers) associated with pre\u2010eclampsia, through a hierarchical systematic literature review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Search Strategy<\/jats:title>\n                    <jats:p>Medline, Embase, Health Technology Assessments, Database of Abstracts of Reviews of Effects, Cochrane Library were searched until April 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Selection Criteria<\/jats:title>\n                    <jats:p>Reviews and cohort studies (&gt;\u2009100 participants) reporting biomarkers associated with pre\u2010eclampsia were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Collection and Analysis<\/jats:title>\n                    <jats:p>Studies were screened by title, then abstract and full text. Evidence was prioritised from umbrella reviews, followed by systematic reviews and then observational studies. Associations were assessed for strength of association and quality of evidence using GRADE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>The biomarker domain included 40 individual determinants of pre\u2010eclampsia. Of these, there were 18 biomarkers with definite or probable associations based on moderate\u2010strong quality evidence across markers of angiogenic imbalance, fetal\u2010placental unit function, inflammatory and immune markers, and physiological markers. Vascular endothelial growth factor, human chorionic gonadotropin, inhibin\u2010A, maternal serum placental protein\u201013, and interferon\u2010gamma had definite associations based on high\u2010quality evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Biomarkers associated with the development of pre\u2010eclampsia highlight the multi\u2010factorial aetiology of the syndrome. The addition of biomarkers, including ultrasound, will optimise the prediction of pre\u2010eclampsia and enable individualised risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.18194","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T09:29:22Z","timestamp":1748338162000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Towards the Development of a Conceptual Framework of the Determinants of Pre\u2010Eclampsia: A Hierarchical Systematic Review of Biomarkers"],"prefix":"10.1111","volume":"133","author":[{"given":"Terteel","family":"Elawad","sequence":"first","affiliation":[{"name":"Department of Women and Children's Health School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiten 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