SP1 is a first trimester maternal serum marker of SGA and preterm delivery.

Early prediction of fetuses being SGA is feasible with the combination of first trimester PAPP-A, beta-hCG and ADAM12. Screening performance is approaching clinical relevance. The inclusion of further markers is an attractive option.

First-trimester screening markers exhibited a significant relation to low birth weight, SGA and to some extent, to pre-term and early pre-term delivery. The screening performance of individual markers was poor.

What are the novel findings of this work?This study is an independent validation of the Fetal Medicine Foundation (FMF) first-trimester screening algorithm for pre-eclampsia, completed in a predominantly white low-risk population in Denmark. We found that the FMF algorithm was effective in the Danish population and it had higher detection rates for preterm pre-eclampsia compared with the current Danish strategy based on single major maternal risk factors. What are the clinical implications of this work?This study supports the superiority and applicability of screening for preterm pre-eclampsia in the first trimester using the FMF algorithm. The results provide evidence for a national implementation of this screening approach in Denmark.