Validation of a preeclampsia early screening test in a Mexican population

Abstract

Background: No preeclampsia screening test has been validated in our country. Objective: To assess the fit and performance of the FMF 4.0 Bayesian algorithm in a Mexican population. Method: Cohort study in singleton pregnancies, according to the competing risks model for preeclampsia. A priori risk was calculated based on medical history. Mean blood pressure (MBP), uterine artery mean pulsatility index (UtAmPI) and pregnancy-associated plasma protein A (PAPP-A) were measured at 11-14 weeks of gestation using standardized methodology. The value of each marker was transformed into multiples of the median (MoM) by the original a algorithm and by population-correction b . Multivariate normal distribution and Bayes theorem were applied to obtain post-test probabilities. Results: There was 5.0% (40/807) of preeclampsia. Distributions in women without preeclampsia were MBP = 0.927 a vs. 0.991 b , UtAmPI = 0.895 a vs. 1.030 b and PAPP-A = 0.815 a vs. 0.963 b (p < 0.001). The AUC was 0.821 a vs. 0.823 b . For a detection rate of 69 %, cutoff points were 1 in 240 a and 1 in 120 b , with false positive rates of 31 % a and 29 % b . Conclusions: The model has to be adjusted to the target population.