Accuracy of second trimester prediction of preterm preeclampsia by three different screening algorithms

Ahmed Al-Amin, Daniel Lorber Rolnik, Carin Black, Adrienne White, Caroline Stolarek, Shaun Brennecke, Fabricio da Silva Costa

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Aim: To compare the performance of three different screening methods (National Institute for Health and Clinical Excellence (NICE) guidelines, American College of Obstetricians and Gynecologists (ACOG) recommendations and Fetal Medicine Foundation (FMF) algorithm) for second trimester prediction of preeclampsia. Methods: This was a prospective non-intervention study in singleton pregnancies, including women attending for second trimester morphologic ultrasound at 19-22 weeks. Maternal characteristics, medical history, mean arterial pressure and mean uterine artery Doppler pulsatility index were recorded and used for risk assessment. Outcomes measured were preeclampsia with delivery before 34, before 37 and after 37 weeks gestation. Detection rates, false positive rates and positive likelihood ratios were calculated, and receiver operating characteristic curves were produced. Results: We screened 543 women during the study. The incidence of preeclampsia before 34, before 37 and after 37 weeks was 0.5, 1.4 and 3.4%, respectively. Detection rates for prediction of preterm preeclampsia were 75% (95% CI 34.9-96.8), 87% (95% CI 47.3-99.6), 100% (95% CI 63.0-100) and 100% (95% CI 63.0-100) for NICE guidelines, ACOG recommendations, FMF algorithm with a 1:100 cut-off and FMF algorithm at 1:60 cut-off, respectively. False positive rates were, 22, 67, 19 and 12% for NICE guidelines, ACOG recommendations, FMF algorithm with a 1:100 cut-off and FMF algorithm at 1:60 cut-off, respectively. Conclusion: Second trimester combined screening for preterm preeclampsia by maternal history, mean arterial pressure and mean uterine artery Doppler pulsatility index (FMF algorithm) was superior to screening by maternal factors alone (NICE guidelines and ACOG recommendations).

Original languageEnglish
Pages (from-to)192-196
Number of pages5
JournalAustralian and New Zealand Journal of Obstetrics and Gynaecology
Volume58
Issue number2
DOIs
Publication statusPublished - Apr 2018

Keywords

  • Mean arterial pressure
  • Preeclampsia
  • Screening
  • Second trimester
  • Uterine artery Doppler

Cite this

@article{363d7d77ec984f7d9c5e78bce4921da5,
title = "Accuracy of second trimester prediction of preterm preeclampsia by three different screening algorithms",
abstract = "Aim: To compare the performance of three different screening methods (National Institute for Health and Clinical Excellence (NICE) guidelines, American College of Obstetricians and Gynecologists (ACOG) recommendations and Fetal Medicine Foundation (FMF) algorithm) for second trimester prediction of preeclampsia. Methods: This was a prospective non-intervention study in singleton pregnancies, including women attending for second trimester morphologic ultrasound at 19-22 weeks. Maternal characteristics, medical history, mean arterial pressure and mean uterine artery Doppler pulsatility index were recorded and used for risk assessment. Outcomes measured were preeclampsia with delivery before 34, before 37 and after 37 weeks gestation. Detection rates, false positive rates and positive likelihood ratios were calculated, and receiver operating characteristic curves were produced. Results: We screened 543 women during the study. The incidence of preeclampsia before 34, before 37 and after 37 weeks was 0.5, 1.4 and 3.4{\%}, respectively. Detection rates for prediction of preterm preeclampsia were 75{\%} (95{\%} CI 34.9-96.8), 87{\%} (95{\%} CI 47.3-99.6), 100{\%} (95{\%} CI 63.0-100) and 100{\%} (95{\%} CI 63.0-100) for NICE guidelines, ACOG recommendations, FMF algorithm with a 1:100 cut-off and FMF algorithm at 1:60 cut-off, respectively. False positive rates were, 22, 67, 19 and 12{\%} for NICE guidelines, ACOG recommendations, FMF algorithm with a 1:100 cut-off and FMF algorithm at 1:60 cut-off, respectively. Conclusion: Second trimester combined screening for preterm preeclampsia by maternal history, mean arterial pressure and mean uterine artery Doppler pulsatility index (FMF algorithm) was superior to screening by maternal factors alone (NICE guidelines and ACOG recommendations).",
keywords = "Mean arterial pressure, Preeclampsia, Screening, Second trimester, Uterine artery Doppler",
author = "Ahmed Al-Amin and Rolnik, {Daniel Lorber} and Carin Black and Adrienne White and Caroline Stolarek and Shaun Brennecke and {da Silva Costa}, Fabricio",
year = "2018",
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doi = "10.1111/ajo.12689",
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journal = "Australian and New Zealand Journal of Obstetrics and Gynaecology",
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Accuracy of second trimester prediction of preterm preeclampsia by three different screening algorithms. / Al-Amin, Ahmed; Rolnik, Daniel Lorber; Black, Carin; White, Adrienne; Stolarek, Caroline; Brennecke, Shaun; da Silva Costa, Fabricio.

In: Australian and New Zealand Journal of Obstetrics and Gynaecology, Vol. 58, No. 2, 04.2018, p. 192-196.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Accuracy of second trimester prediction of preterm preeclampsia by three different screening algorithms

AU - Al-Amin, Ahmed

AU - Rolnik, Daniel Lorber

AU - Black, Carin

AU - White, Adrienne

AU - Stolarek, Caroline

AU - Brennecke, Shaun

AU - da Silva Costa, Fabricio

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KW - Mean arterial pressure

KW - Preeclampsia

KW - Screening

KW - Second trimester

KW - Uterine artery Doppler

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