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- Title
Accuracy of competing-risks model in screening for pre-eclampsia by maternal factors and biomarkers at 11-13 weeks' gestation.
- Authors
O'Gorman, N.; Wright, D.; Poon, L. C.; Rolnik, D. L.; Syngelaki, A.; Wright, A.; Akolekar, R.; Cicero, S.; Janga, D.; Jani, J.; Molina, F. S.; de Paco Matallana, C.; Papantoniou, N.; Persico, N.; Plasencia, W.; Singh, M.; Nicolaides, K. H.
- Abstract
<bold>Objective: </bold>To examine the diagnostic accuracy of a previously developed model for prediction of pre-eclampsia (PE) by a combination of maternal factors and biomarkers at 11-13 weeks' gestation.<bold>Methods: </bold>This was a prospective first-trimester multicenter study of screening for PE in 8775 singleton pregnancies. A previously published algorithm was used for the calculation of patient-specific risk of PE in each individual. The detection rates (DRs) and false-positive rates (FPRs) for delivery with PE < 32, < 37 and ≥ 37 weeks were estimated and compared with those for the dataset used for development of the algorithm.<bold>Results: </bold>In the study population, 239 (2.7%) cases developed PE, of which 17 (0.2%), 59 (0.7%) and 180 (2.1%) developed PE < 32, < 37 and ≥ 37 weeks, respectively. With combined screening by maternal factors, mean arterial pressure, uterine artery pulsatility index and serum placental growth factor, the DR was 100% (95% CI, 80-100%) for PE < 32 weeks, 75% (95% CI, 62-85%) for PE < 37 weeks and 43% (95% CI, 35-50%) for PE ≥ 37 weeks, at a 10% FPR. These DRs were similar to the estimated rates for the dataset used for development of the model: 89% (95% CI, 79-96%) for PE < 32 weeks, 75% (95% CI, 70-80%) for PE < 37 weeks and 47% (95% CI, 44-51%) for PE ≥ 37 weeks.<bold>Conclusion: </bold>Assessment of a combination of maternal factors and biomarkers at 11-13 weeks provides effective first-trimester screening for preterm PE. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
- Subjects
EUROPE; FIRST trimester of pregnancy; PLACENTAL growth factor; BAYES' theorem; PREECLAMPSIA; BLOOD proteins; PRENATAL care; UTERINE artery; ARTERIAL physiology; PREECLAMPSIA diagnosis; COMPARATIVE studies; GESTATIONAL age; LONGITUDINAL method; MATHEMATICAL models; RESEARCH methodology; MEDICAL cooperation; PHYSICS; PRENATAL diagnosis; RESEARCH; RISK assessment; THEORY; EVALUATION research
- Publication
Ultrasound in Obstetrics & Gynecology, 2017, Vol 49, Issue 6, p751
- ISSN
0960-7692
- Publication type
journal article
- DOI
10.1002/uog.17399