Document Detail


A competing risks model in early screening for preeclampsia.
MedLine Citation:
PMID:  22846473     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: It was the aim of this study to develop models for the prediction of preeclampsia (PE) based on maternal characteristics and biophysical markers at 11-13 weeks' gestation in which gestation at the time of delivery for PE is treated as a continuous variable.
METHODS: This was a screening study of singleton pregnancies at 11-13 weeks including 1,426 (2.4%) cases that subsequently developed PE and 57,458 cases that were unaffected by PE. We developed a survival time model for the time of delivery for PE in which Bayes' theorem was used to combine the prior information from maternal characteristics with the uterine artery pulsatility index (PI) and the mean arterial pressure (MAP), using multiple of the median values.
RESULTS: The risk for PE increased with maternal age, weight, Afro-Caribbean and South Asian racial origin, previous pregnancy with PE, conception by in vitro fertilization and a medical history of chronic hypertension, type 2 diabetes mellitus as well as systemic lupus erythematosus or antiphospholipid syndrome. In pregnancies with PE, there was an inverse correlation between multiple of the median values of the uterine artery PI and MAP with gestational age at delivery. Screening by maternal characteristics, uterine artery PI and MAP detected 90% of PE cases requiring delivery before 34 weeks and 57% of all PE cases at a fixed false-positive rate of 10%.
CONCLUSIONS: A new model has been developed for effective first-trimester screening for PE.
Authors:
David Wright; Ranjit Akolekar; Argyro Syngelaki; Leona C Y Poon; Kypros H Nicolaides
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-07-27
Journal Detail:
Title:  Fetal diagnosis and therapy     Volume:  32     ISSN:  1421-9964     ISO Abbreviation:  Fetal. Diagn. Ther.     Publication Date:  2012  
Date Detail:
Created Date:  2012-11-22     Completed Date:  2013-04-29     Revised Date:  2013-09-13    
Medline Journal Info:
Nlm Unique ID:  9107463     Medline TA:  Fetal Diagn Ther     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  171-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 S. Karger AG, Basel.
Affiliation:
School of Computing and Mathematics, Plymouth University, Plymouth, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
African Continental Ancestry Group
Arterial Pressure
Asian Continental Ancestry Group
Biological Markers
Early Diagnosis
Female
Fertilization in Vitro / adverse effects
Humans
Models, Biological*
Pre-Eclampsia / ethnology,  etiology,  physiopathology,  ultrasonography*
Pregnancy
Pregnancy Complications / physiopathology
Pregnancy Trimester, First
Prospective Studies
Pulsatile Flow
Recurrence
Risk Factors
Ultrasonography, Prenatal*
Uterine Artery / physiopathology,  ultrasonography*
Chemical
Reg. No./Substance:
0/Biological Markers
Comments/Corrections
Erratum In:
Fetal Diagn Ther. 2013;34(1):18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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