First‐trimester markers for the prediction of pre‐eclampsia in women with <i>a‐priori</i> high risk

Khalil, Asma; Cowans, Nicholas J.; Spencer, Kevin; Goichman, Sergey; Meiri, Hamutal; Harrington, Kevin

doi:10.1002/uog.7559

Cited by 99 publications

(86 citation statements)

References 53 publications

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“…[7][8][9][10][11][12][13][14][15] However, less remarkable predictive properties have been reported in recent studies, with some describing a potential role of PP13 levels for predicting preeclampsia or small for gestational age (SGA) in combination with other biomarkers. [9,12,15] Variation in study design, population characteristics, numbers of cases and reporting of the diagnostic accuracy of PP13, have made it difficult to interpret the clinical significance of these results.…”

Section: Introductionmentioning

confidence: 99%

First trimester screening of maternal placental protein 13 for predicting preeclampsia and small for gestational age: In-house study and systematic review

et al. 2012

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Objective: To describe normative levels of PP13 in first-trimester of pregnancy and determine the accuracy of PP13 in predicting preeclampsia and small for gestational age (SGA) infants.Methods: We measured PP13 in archived first trimester serum samples from an unselected maternal cohort of 2,989 women. Associations of PP13 levels and diagnostic accuracy in predicting adverse pregnancy outcomes were assessed using multivariate logistic regression models. Due to inadequate number of cases we then conducted a systematic review involving structured search of electronic databases and subsequent meta-analysis of predictive accuracy using data from similar studies.Results: Overall, 2,678 women were included in the in-house study with 71 (2.7%) preeclampsia cases, 5 (0.2%) early-onset preeclampsia (≤34 weeks) cases; and 191 (7.1%) and 41 (1.5%) infants SGA<10 th and <3 rd centile. Median (IQR) normative level of PP13 in unaffected pregnancies was 53.5 (37.7-71.8) pg/ml. The area under the receiver operating characteristic curve (AUC) for multivariate models was 0.72 (95%CI 0.66-0.78) for preeclampsia; 0.82 (95%CI 0.63-0.99) for early-onset preeclampsia; 0.73 (95%CI 0.69-0.77) for SGA<10 th centile; and 0.83 (95%CI 0.78-0.88) for SGA<3 rd centile. Eight studies were included in the systematic review, normative levels of PP13 was assessed in four studies but these were variable; and meta-analysis was performed on seven studies. Sensitivity rates of PP13 based on 5% fixed false positive rates were 24%, 45% and 26% for preeclampsia, for early-onset preeclampsia and SGA, respectively.Conclusions: First-trimester PP13, in combination with maternal characteristics and other serum biomarkers was inadequate for screening purposes and predicting women at risk.

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Section: Introductionmentioning

confidence: 99%

First trimester screening of maternal placental protein 13 for predicting preeclampsia and small for gestational age: In-house study and systematic review

et al. 2012

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“…В последнее время в зарубежной ли-тературе появились новые сведения о значении показате-лей центрального АД и ригидности артерий, измеренных с помощью неинвазивных методов у беременных. Иссле-дования показали, что у беременных с ПЭ отмечалось по-вышение жесткости артерий и центрального АД по срав-нению с таковыми у женщин с ГАГ и нормально протека-ющей беременностью [9,16,17]. Повышение ригидности артерий тесно взаимосвязано с дисфункцией эндотелия [18,19].…”

Section: Discussionunclassified

Estimation of central blood pressure and arterial stiffness in pregnant women with different forms of hypertension

Чулков¹,

Vereina²,

Sp³

et al. 2014

Ter. arkh.

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РезюмеЦель исследования. Оценить показатели центрального (аортального) артериального давления (АД) и ригидности артерий и их прогностическую значимость в отношении развития преэклампсии (ПЭ) у беременных с различными формами артериальной гипертонии (АГ). Материалы и методы. В исследование включили 106 пациенток с хронической АГ, 21 пациентку с хронической АГ и присоединившейся ПЭ, 63 пациентки с гестационной АГ, 10 пациенток с ПЭ и 100 женщин без АГ. Всем женщинам выполнено суточное мониторирование АД осциллометрическим методом измерения с определением центрального (аортального) АД и параметров ригидности артерий на сроках 16-22 нед беременности. Результаты. У беременных с ПЭ оказались наиболее высокие показатели среднесуточного центрального систолического и диастолического АД. Наиболее значимым для прогнозирования ПЭ по результатам ROC-анализа явилось среднесуточное аортальное систолическое АД выше 115 мм рт.ст. У беременных с ПЭ на фоне хронической АГ выявлены наиболее высокие показатели ригидности артерий (индекс аугментации, индекс ригидности, максимальная скорость нарастания АД). Заключение. Проведение суточного мониторирования АД у беременных позволяет получить дополнительные характеристики, отражающие ригидность аорты и периферических артерий, которые могут использоваться для прогнозирования ПЭ.Ключевые слова: артериальная гипертония, беременность, центральное (аортальное) артериальное давление, ригидность артерий.Aim. To estimate central (aortic) blood pressure (BP) and arterial stiffness and their prognostic value in the development of preeclampsia (PE) in pregnant women with different forms of hypertension. Subjects and methods. The study included 106 patients with chronic hypertension, 21 with the latter concurrent with PE, 63 with gestational hypertension, 10 with PE, and 100 without hypertension. All the women underwent 24-hour BP monitoring by an oscillometric method to estimate central (aortic) BP and arterial stiffness at 16-22 weeks' gestation. Results. The highest average daily central systolic and diastolic BP was in the pregnant women with PE. ROC analysis showed that the average daily aortic systolic BP greater than 115 mm Hg was most significant for the prediction of PE. The highest values of arterial stiffness (augmentation index, stiffness, maximum rate of blood pressure rise) were detected in the pregnant women with PE in the presence of chronic hypertension. Conclusion. 24-four BP monitoring in pregnant women can provide additional characteristics that reflect the stiffness of the aorta and peripheral arteries, which may be used to predict PE. Key words: hypertension, pregnancy, central (aortic) blood pressure, arterial stiffness.АГ -артериальная гипертония АД -артериальное давление ГАГ -гестационная АГ ДАД -диастолическое АД ДИ -доверительный интервал ПЭ -преэклампсия САД -систолическое АД СМАД -суточное мониторирование АД ХАГ -хроническая АГ +LR -прогностическая ценность положительного результата AASI -амбулаторный индекс ригидности жесткости артерий AIx 75 (augmentation index) -индек...

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“…As a first trimester screening marker for PE, PP13 shows different prediction rates in different studies. In two different cohort studies, PP13 levels were determined at 11 + 0 to 13 + 6 weeks of gestation [33,34]. At false positive rates of 5% and 10% they found detection rates of 37.5% and 69% respectively, using PP13 as a single biochemical marker.…”

Section: Placental Protein 13mentioning

confidence: 99%

“…It seems that a combination of PP13 and uterine artery Doppler PI is a better prediction test for preeclampsia than either test alone, either if performed simultaneously in gestational week 11-14. When combining serum screening with Doppler ultrasound pulsatility index (PI), the prediction rate increased to 71% at a false positive rate of 10% [34]. Nicolaides et al found that PP13 is a biochemical marker for early onset PE in gestational week 11-14 [35].…”

Section: Placental Protein 13mentioning

confidence: 99%

Prediction of the preeclampsia: a view of biochemical markers

Bostancı

Bayram

Cevrioğlu

et al. 2013

RHC

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Preeclampsia is a diverse, multiorgan group of related disease processes that occurs in up to 5%-8% of pregnancies after 20 weeks' gestation and it is one of the leading causes of maternal and fetal morbidity and mortality. Many molecular mechanisms are contributed to the pathogenesis of preeclampsia. Although it is unknown whether the mechanisms act independently or have synergistic effects. This review describes review of primary papers investigating blood based biomarker such as PAP-A, Inhibin A, sFlt1, and PP13 in general and first trimester biochemical markers and combinations of them specifically for preeclampsia.

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First‐trimester markers for the prediction of pre‐eclampsia in women with a‐priori high risk

Abstract: Objective

Cited by 99 publications

References 53 publications

First trimester screening of maternal placental protein 13 for predicting preeclampsia and small for gestational age: In-house study and systematic review

First trimester screening of maternal placental protein 13 for predicting preeclampsia and small for gestational age: In-house study and systematic review

Estimation of central blood pressure and arterial stiffness in pregnant women with different forms of hypertension

Prediction of the preeclampsia: a view of biochemical markers

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