Comparison of Carotid Intima Media Thickness between Women with History of Preeclampsia and Normal Pregnancy: A Meta-Analysis of Systematic Review

Abstract

Background: Women with a history of preeclampsia are twice as likely to experience long term cardiovascular disease (CVD) compared to women with unaffected pregnancy. The pathophysiology of preeclampsia is not well understood, however there is general agreement that, similar to cardiovascular disease, endothelial dysfunction plays a crucial role. On a clinical level, preeclampsia and atherosclerotic cardiovascular disease share common risk factors. Carotid intima media thickness (CIMT) is ultrasound-based imaging, non-invasive, simple and reproducible method of subclinical atherosclerosis evaluation. Nowadays, there were studies concerning of CIMT among preeclamptic women, although the results were different. Objective: To prove that CIMT among women with histories of preeclampsia was greater compared to normal pregnancy. Methods: We conducted a meta-analysis of studies that reported CIMT, in women who had preeclampsia and had normal pregnancy. Studies were identified through three databases: PubMed, Google Scholar dan SAGE Journals with publication year of 2010-2020. Heterogeneity was assessed using the I2 statistic. Standardized mean difference was used as measured of effect size. Results: Nine eligible studies were included in the meta-analysis. This meta-analysis consisted of 439 women with preeclampsia histories and 526 women with normal pregnancy histories. Women who had preeclampsia had significantly higher CIMT compared to those with normal pregnancy with standardized mean difference -0.38 and 95% confidence interval (CI) -0.68 to -0.07 (p=0.02). Conclusion: CIMT was greater among women with histories of preeclampsia compared to normal pregnancy.