TY - JOUR
T1 - Accuracy of competing-risks model in screening for pre-eclampsia by maternal factors and biomarkers at 11–13 weeks' gestation
AU - O'Gorman, N.
AU - Wright, D.
AU - Poon, L. C.
AU - Rolnik, D. L.
AU - Syngelaki, A.
AU - Wright, A.
AU - Akolekar, R.
AU - Cicero, S.
AU - Janga, D.
AU - Jani, J.
AU - Molina, F. S.
AU - de Paco Matallana, C.
AU - Papantoniou, N.
AU - Persico, N.
AU - Plasencia, W.
AU - Singh, M.
AU - Nicolaides, K. H.
PY - 2017/6
Y1 - 2017/6
N2 - Objective: To examine the diagnostic accuracy of a previously developed model for prediction of pre-eclampsia (PE) by a combination of maternal factors and biomarkers at 11–13 weeks' gestation. Methods: This was a prospective first-trimester multicenter study of screening for PE in 8775 singleton pregnancies. A previously published algorithm was used for the calculation of patient-specific risk of PE in each individual. The detection rates (DRs) and false-positive rates (FPRs) for delivery with PE < 32, < 37 and ≥ 37 weeks were estimated and compared with those for the dataset used for development of the algorithm. Results: In the study population, 239 (2.7%) cases developed PE, of which 17 (0.2%), 59 (0.7%) and 180 (2.1%) developed PE < 32, < 37 and ≥ 37 weeks, respectively. With combined screening by maternal factors, mean arterial pressure, uterine artery pulsatility index and serum placental growth factor, the DR was 100% (95% CI, 80–100%) for PE < 32 weeks, 75% (95% CI, 62–85%) for PE < 37 weeks and 43% (95% CI, 35–50%) for PE ≥ 37 weeks, at a 10% FPR. These DRs were similar to the estimated rates for the dataset used for development of the model: 89% (95% CI, 79–96%) for PE < 32 weeks, 75% (95% CI, 70–80%) for PE < 37 weeks and 47% (95% CI, 44–51%) for PE ≥ 37 weeks. Conclusion: Assessment of a combination of maternal factors and biomarkers at 11–13 weeks provides effective first-trimester screening for preterm PE.
AB - Objective: To examine the diagnostic accuracy of a previously developed model for prediction of pre-eclampsia (PE) by a combination of maternal factors and biomarkers at 11–13 weeks' gestation. Methods: This was a prospective first-trimester multicenter study of screening for PE in 8775 singleton pregnancies. A previously published algorithm was used for the calculation of patient-specific risk of PE in each individual. The detection rates (DRs) and false-positive rates (FPRs) for delivery with PE < 32, < 37 and ≥ 37 weeks were estimated and compared with those for the dataset used for development of the algorithm. Results: In the study population, 239 (2.7%) cases developed PE, of which 17 (0.2%), 59 (0.7%) and 180 (2.1%) developed PE < 32, < 37 and ≥ 37 weeks, respectively. With combined screening by maternal factors, mean arterial pressure, uterine artery pulsatility index and serum placental growth factor, the DR was 100% (95% CI, 80–100%) for PE < 32 weeks, 75% (95% CI, 62–85%) for PE < 37 weeks and 43% (95% CI, 35–50%) for PE ≥ 37 weeks, at a 10% FPR. These DRs were similar to the estimated rates for the dataset used for development of the model: 89% (95% CI, 79–96%) for PE < 32 weeks, 75% (95% CI, 70–80%) for PE < 37 weeks and 47% (95% CI, 44–51%) for PE ≥ 37 weeks. Conclusion: Assessment of a combination of maternal factors and biomarkers at 11–13 weeks provides effective first-trimester screening for preterm PE.
KW - Bayes' theorem
KW - first-trimester screening
KW - mean arterial pressure
KW - placental growth factor
KW - pre-eclampsia
KW - pregnancy-associated plasma protein-A
KW - pyramid of pregnancy care
KW - survival model
KW - uterine artery Doppler
UR - http://www.scopus.com/inward/record.url?scp=85011922028&partnerID=8YFLogxK
U2 - 10.1002/uog.17399
DO - 10.1002/uog.17399
M3 - Article
C2 - 28067011
AN - SCOPUS:85011922028
VL - 49
SP - 751
EP - 755
JO - Ultrasound in Obstetrics and Gynecology
JF - Ultrasound in Obstetrics and Gynecology
SN - 0960-7692
IS - 6
ER -