MiRNAs as biomarkers for diagnosis of neonatal sepsis: a systematic review and meta-analysis

Abstract

Background

The relationship between circulating miRNAs and neonatal sepsis and the mechanism of action are still unclear at this time. Therefore, the potential diagnostic role of miRNAs in neonatal sepsis (NS) was studied through meta-analysis.

Method

Web of Science, Cochrane Library, PubMed, and Embase are retrieved, supplemented by manual search, and the search was conducted to find related studies without time limit until May 2022.The quality of the literature was assessed via QUADAS criteria and meta-analyzed via Stata 11.0 software, including the assessment of specificity, sensitivity, likelihood ratio and diagnostic odds ratio. Then, sensitivity analysis and heterogeneity testing were conducted, and finally, the summary receiver operating characteristics (SROC) curve was drawn.

Result

This study included 14 articles, including 20 miRNAs and 1597 newborns(control group: 727 and case group: 870). Among them, one article was of low quality, three articles were of high quality, and the rest were of medium quality. According to the results of random effects model analysis, the pooled specificity and sensitivity of miRNA for the diagnosis of NS were 0.83 (95%CI: 0.79–0.87) and 0.76 (95%CI: 0.72–0.80), respectively. And negative likelihood ratio, positive likelihood ratio, and diagnostic odds ratio were 0.29 (95%CI: 0.24–0.34), 4.51 (95%CI: 3.52–5.78), and 15.81 (95%CI: 10.71–23.35), respectively. The area under the SROC curve was 0.86, and there was no evidence publication bias detected in the funnel plot.

Conclusion

Circulating miRNAs may be very useful in the development of early diagnostic strategies for neonatal sepsis.

Keywords:

• Neonatal sepsis
• MiRNAs
• diagnosis
• meta-analysis
• systematic review

Author contributions

WXH and SBL co-conceptualized and designed the study, performed the initial screening of the articles, performed initial analyses including risk of bias assessment, drafted the manuscript, and provided methodological and statistical expertise in data analyses and interpretation. NW double checked the initial screening of articles and double checked all the data extraction from included studies. XQC devised the search strategy for the systematic review based on study protocol. JJM and JJL assisted in the conduct of the systematic review, provided logistical support, reviewed the study protocol, and helped revise the manuscript. LH and CJR co-conceptualized and designed the study, provided guidance in the conduct of the review and meta-analysis, oversaw the conduct of all meta-analyses, revised the initial manuscript draft, and approved the final version.

Disclosure statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Data availability statement

The original contributions presented in the study are included in the article/Supplementary Material, further inquiries can be directed to the corresponding authors.

Additional information

Funding

This study was supported by Hebei Province Science and Technology Support Program, China under Grant No.21377738D.