Document Detail


First-trimester prediction of preterm birth using ADAM12, PAPP-A, uterine artery Doppler, and maternal characteristics.
MedLine Citation:
PMID:  22847849     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of this study was to estimate the efficiency of first-trimester a disintegrin and metalloprotease 12 (ADAM12), pregnancy-associated plasma protein A (PAPP-A), uterine artery Doppler, and maternal characteristics in the prediction of preterm birth (PTB).
METHODS: This was a prospective cohort study of patients presenting for first-trimester aneuploidy screening. Maternal serum ADAM12 and PAPP-A levels were measured by immunoassay, and mean uterine artery Doppler pulsatility indices were calculated. The primary outcome was PTB <34 weeks' gestation, and the secondary outcome was PTB <37 weeks' gestation. Logistic regression was used to model the prediction of PTB using ADAM12, PAPP-A, uterine artery Doppler, and maternal characteristics, individually and in combination. Sensitivity, specificity, and area under the receiver-operating characteristic curves were compared between models.
RESULTS: Of 578 patients, 36 (6.2%) delivered <34 weeks, and 78 (13.5%) delivered <37 weeks. For a 20% fixed false positive rate, ADAM12, PAPP-A, and uterine artery Doppler identified 58%, 52%, and 62% of patients with PTB <34 weeks and 42%, 48%, and 50% of patients with PTB <37 weeks, respectively. Combining these first-trimester parameters did not improve the predictive efficiency of the models.
CONCLUSION: First-trimester ADAM12, PAPP-A, and uterine artery Doppler are each modestly predictive of PTB; however, combinations of these parameters do not further improve their screening efficiency.
Authors:
Katherine R Goetzinger; Alison G Cahill; Janet Kemna; Linda Odibo; George A Macones; Anthony O Odibo
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-07-31
Journal Detail:
Title:  Prenatal diagnosis     Volume:  32     ISSN:  1097-0223     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-02     Completed Date:  2013-03-04     Revised Date:  2013-10-17    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  1002-7     Citation Subset:  IM    
Copyright Information:
© 2012 John Wiley & Sons, Ltd.
Affiliation:
Department of Obstetrics & Gynecology, Washington University in St. Louis, St. Louis, MO, USA. goetzingerk@wudosis.wustl.edu
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MeSH Terms
Descriptor/Qualifier:
ADAM Proteins / blood*
Adult
African Americans
Body Mass Index
Cohort Studies
False Positive Reactions
Female
Gestational Age*
Humans
Maternal Age
Membrane Proteins / blood*
Pregnancy
Pregnancy Complications
Pregnancy Trimester, First
Pregnancy-Associated Plasma Protein-A / analysis*
Premature Birth / diagnosis*,  ethnology
Prenatal Diagnosis / methods*
Prospective Studies
Pulsatile Flow
ROC Curve
Sensitivity and Specificity
Uterine Artery / ultrasonography*
Grant Support
ID/Acronym/Agency:
5T32 HD055172/HD/NICHD NIH HHS; T32 HD055172/HD/NICHD NIH HHS; UL1 RR024992/RR/NCRR NIH HHS; UL1 TR000448/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
0/Membrane Proteins; EC 3.4.24.-/ADAM 12 protein; EC 3.4.24.-/ADAM Proteins; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A
Comments/Corrections

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