Accuracy of competing-risks model in screening for pre-eclampsia by maternal factors and biomarkers at 11–13 weeks' gestation
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AbstractObjective 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.
All Author(s) ListO'Gorman N., Wright D., Poon L.C., Rolnik D.L., Syngelaki A., Wright A., Akolekar R., Cicero S., Janga D., Jani J., Molina F.S., Paco Matallana C., Papantoniou N., Persico N., Plasencia W., Singh M., Nicolaides K.H.
Journal nameUltrasound in Obstetrics and Gynaecology
Detailed descriptionUOG-2016-1022.R1
Prof POON, Chiu Yee Liona is a senior author
Year2017
Month6
Volume Number49
Issue Number6
PublisherJohn Wiley & Sons, Ltd
Place of PublicationUS
Pages751 - 755
ISSN0960-7692
LanguagesEnglish-United States
KeywordsBayes' theorem, first-trimester screening, mean arterial pressure, placental growth factor, pre-eclampsia, pregnancy-associated plasma protein-A, pyramid of pregnancy care, survival model, uterine artery Doppler

Last updated on 2020-27-05 at 02:44