Evaluation of Down's syndrome screening population data sets by simulation: analyser-specific parameters may be superior to meta-analysis-derived parameters

BACKGROUND: Early identification of women with an increased risk for preeclampsia is of utmost importance to minimize adverse perinatal events. Models developed until now (mainly multiparametric algorithms) are thought to be overfitted to the derivation population, which may affect their reliability when applied to other populations. Options allowing adaptation to a variety of populations are needed. OBJECTIVE: The objective of the study was to assess the performance of a first-trimester multivariate Gaussian distribution model including maternal characteristics and biophysical/biochemical parameters for screening of early-onset preeclampsia (delivery <34 weeks of gestation) in a routine care low-risk setting. STUDY DESIGN: Early-onset preeclampsia screening was undertaken in a prospective cohort of singleton pregnancies undergoing routine first-trimester screening (8 weeks 0/7 days to 13 weeks 6/7 days of gestation), mainly using a 2-step scheme, at 2 hospitals from March 2014 to September 2017. A multivariate Gaussian distribution model including maternal characteristics (a priori risk), serum pregnancy-associated plasma protein-A and placental growth factor assessed at 8 weeks 0/7 days to 13 weeks 6/7 days and mean arterial pressure and uterine artery pulsatility index measured at 11.0e13.6 weeks was used.RESULTS: A total of 7908 pregnancies underwent examination, of which 6893 were included in the analysis. Incidence of global preeclampsia was 2.3% (n ¼ 161), while of early-onset preeclampsia was 0.2% (n ¼ 17). The combination of maternal characteristics, biophysical parameters, and placental growth factor showed the best detection rate, which was 59% for a 5% false-positive rate and 94% for a 10% falsepositive rate (area under the curve, 0.96, 95% confidence interval, 0.94e0.98). The addition of placental growth factor to biophysical markers significantly improved the detection rate from 59% to 94%. CONCLUSION: The multivariate Gaussian distribution model including maternal factors, early placental growth factor determination (at 8 weeks 0/7 days to 13 weeks 6/7 days), and biophysical variables (mean arterial pressure and uterine artery pulsatility index) at 11 weeks 0/7 days to 13 weeks 6/7 days is a feasible tool for early-onset preeclampsia screening in the routine care setting. Performance of this model should be compared with predicting models based on regression analysis.

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A new model for screening for early-onset preeclampsia

Serra

Mendoza

Scazzocchio

et al. 2020

American Journal of Obstetrics and Gynecology

110

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Differences in second trimester risk estimates for trisomy 21 between Maglumi X3/Preaccu and Immulite/Prisca systems

Üstündağ,

Huysal,

Yeşil

2024

Turkish Journal of Biochemistry

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Objectives Maternal serum alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG) or free βHCG, and unconjugated estriol (uE3) concentrations are used to screen trisomy 21 in the second trimester. The performance of different analytical platforms has an impact on individual risk estimates. The aim of this study is to compare the multiple of median (MoM) values and risk estimates generated by Maglumi X3 analyzer/Preaccu software with the Immulite 2000 XPi device/Prisca software. Methods 164 pregnant women (including 20 pregnants with risk estimates above ≥1 in 250 for trisomy 21) analyzed with both platforms. Results Passing–Bablok indicated proportional bias (0.75 [95 % CI 0.70 to 0.82]) between AFP MoMs and both systematic (−0.20 [95 % CI –0.33 to −0.05]) and proportional (1.25 [95 % CI 1.06 to 1.44]) differences between the HCG/free βHCG MoMs, respectively. No significant differences (p=0.070) were present between calculated individual risks by both of the programmes (estimated median risk with Immulite/Prisca system was 1 in 1890 and 1 in 1220 with Maglumi X3/Preaccu system). The triple test result for three pregnant women was negative with the Prisca program, it was positive with the Preaccu. Conclusions Second trimester screening performance of Maglumi X3/Preaccu system achieves comparable performance. Determining regional median values before using will provide more accurate and reliable results.

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The analysis of second-trimester triple screening for Down syndrome in Chinese normal singleton pregnancies

Wan

Wen

Song

et al. 2012

Scandinavian Journal of Clinical and Laboratory Investigation

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Evaluation of Down's syndrome screening population data sets by simulation: analyser-specific parameters may be superior to meta-analysis-derived parameters

Cited by 3 publications

References 19 publications

A new model for screening for early-onset preeclampsia

A new model for screening for early-onset preeclampsia

Differences in second trimester risk estimates for trisomy 21 between Maglumi X3/Preaccu and Immulite/Prisca systems

The analysis of second-trimester triple screening for Down syndrome in Chinese normal singleton pregnancies

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