Document Detail


Competing risks model in early screening for preeclampsia by biophysical and biochemical markers.
MedLine Citation:
PMID:  22906914     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To develop models for prediction of preeclampsia (PE) based on maternal characteristics, biophysical and biochemical markers at 11-13 weeks' gestation in which the 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%) that subsequently developed PE and 57,458 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 uterine artery pulsatility index (PI), mean arterial pressure (MAP), serum pregnancy-associated plasma protein-A (PAPP-A) and placental growth factor (PLGF) multiple of the median (MoM) values.
RESULTS: In pregnancies with PE, there was a linear correlation between MoM values of uterine artery PI, MAP, PAPP-A and PLGF with gestational age at delivery and therefore the deviation from normal was greater for early than late PE for all four biomarkers. Screening by maternal characteristics, biophysical and biochemical markers detected 96% of cases of PE requiring delivery before 34 weeks and 54% of all cases of PE at a fixed false-positive rate of 10%.
CONCLUSIONS: A new model has been developed for effective first-trimester screening for PE.
Authors:
Ranjit Akolekar; Argyro Syngelaki; Leona Poon; David Wright; Kypros H Nicolaides
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-08-16
Journal Detail:
Title:  Fetal diagnosis and therapy     Volume:  33     ISSN:  1421-9964     ISO Abbreviation:  Fetal. Diagn. Ther.     Publication Date:  2013  
Date Detail:
Created Date:  2013-01-18     Completed Date:  2013-06-28     Revised Date:  2013-09-13    
Medline Journal Info:
Nlm Unique ID:  9107463     Medline TA:  Fetal Diagn Ther     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  8-15     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 S. Karger AG, Basel.
Affiliation:
Harris Birthright Research Centre of Fetal Medicine, King’s College Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Blood Pressure
Female
Gestational Age
Humans
Mass Screening*
Models, Statistical*
Pre-Eclampsia / blood,  diagnosis*
Pregnancy
Pregnancy Proteins / blood*
Pregnancy Trimester, First
Pregnancy-Associated Plasma Protein-A / metabolism*
Risk Assessment
Uterine Artery / ultrasonography
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Pregnancy Proteins; 144589-93-5/placenta growth factor; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A; EC 3.4.24.79/PAPPA1 protein, human
Comments/Corrections
Erratum In:
Fetal Diagn Ther. 2013;34(1):43

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


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