Validation of a first-trimester screening model for pre-eclampsia in an unselected population

Scazzocchio, Elena; Crovetto, F.; Triunfo, Stefania; Gratacós, E.; Figueras, F.

doi:10.1002/uog.15982

Cited by 28 publications

(30 citation statements)

References 38 publications

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“…A clear linear independent association between UtA‐PI values in the first trimester and the risk of PE has been reported consistently in previous studies. Hence, the fact that higher mean UtA‐PI values will inevitably lead to an increased screen‐positive rate is expected, if the other markers are held constant and assuming that they should not vary according to UtA‐PI operators.…”

Section: Discussionsupporting

confidence: 66%

Quality assessment of uterine artery Doppler measurement in first‐trimester combined screening for pre‐eclampsia

Rolnik

Costa

Sahota

et al. 2019

Ultrasound in Obstet & Gyne

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Section: Discussionsupporting

confidence: 66%

Quality assessment of uterine artery Doppler measurement in first‐trimester combined screening for pre‐eclampsia

Rolnik

Costa

Sahota

et al. 2019

Ultrasound in Obstet & Gyne

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“…The model developed by Scazzocchio et al, 44 which included maternal factors, mean arterial pressure, mean uterine artery-PI, and PAPP-A, achieved detection rates of 69% and 81% for 5% and 10% false-positive rates, respectively, with a recently published internal validation study having reported similar figures. 45 Detection rates reported by the same group 46 using maternal factors, mean arterial pressure, uterine artery-PI, and PlGF in another multiparametric algorithm were 82% and 89% for 5% and 10% false-positive rate, respectively.…”

Section: Principal Findingsmentioning

confidence: 94%

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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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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“…Algorithms to calculate the risk for early or late PE have been developed, combining some of these markers with the background risk defined by maternal history. The performance of such a screening is best for early PE requiring delivery before 34 weeks of gestation, but the detection of later PE is also possible [6,[11][12][13] . Placental growth factor (PlGF) is one of the most important firsttrimester biochemical markers for PE.…”

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confidence: 99%

Importance of Timing First-Trimester Placental Growth Factor and Use of Serial First-Trimester Placental Growth Factor Measurements in Screening for Preeclampsia

Mosimann

Amylidi-Mohr²,

Höland³

et al. 2017

Fetal Diagn Ther

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Objective: The aims of this study were to test whether the performance of first-trimester placental growth factor (PlGF) in screening for preterm preeclampsia (PE) is gestational age dependent and to assess the value of serial first-trimester PlGF measurements in discriminating women at risk for PE. Methods: PlGF was measured in women with singleton pregnancies at their first antenatal visit at 8+0 to 10+6 and additionally at 11+0 to 14+0 weeks of gestation. The difference in absolute values of serial PlGF measurements was expressed as Δ-PlGF. Values were compared between pregnancies with normal outcome and those complicated by PE. Results: A total of 814 pregnancies were included, 18 (2.19%) developed PE that required delivery before 37 weeks of gestation. PlGF increases significantly from 8 to 14 weeks of gestation (ρ = 0.63; p < 0.0001) in normal pregnancies, but not so in preterm PE (ρ = 0.034; p = 0.893). PlGF discriminates between PE and uneventful pregnancies only after 10 weeks of gestation. Δ-PlGF was significantly lower in PE 5.3 (-1.1 to 9.3) pg/mL compared to uneventful pregnancies 17.3 (9.8-26.0) pg/mL (p = 0.0011). Conclusion: The discriminatory accuracy of PlGF increases from 10 to 14 weeks of gestation, and serial PlGF measurements might be of particular interest in PE screening.

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Validation of a first-trimester screening model for pre-eclampsia in an unselected population

Abstract: The prediction model for PE achieved a similar performance to that obtained in the construction cohort when tested on a subsequent cohort of women, confirming its validity as a predictive model for PE. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Cited by 28 publications

References 38 publications

Quality assessment of uterine artery Doppler measurement in first‐trimester combined screening for pre‐eclampsia

Quality assessment of uterine artery Doppler measurement in first‐trimester combined screening for pre‐eclampsia

A new model for screening for early-onset preeclampsia

Importance of Timing First-Trimester Placental Growth Factor and Use of Serial First-Trimester Placental Growth Factor Measurements in Screening for Preeclampsia

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