New Predictive Model at 11+0 to 13+6 Gestational Weeks for Early-Onset Preeclampsia With Fetal Growth Restriction
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Published on: June 29, 2013
Ying Chang1, Xu Chen1, Hong-Yan Cui1
11 Obstetrics Department, Tianjin Center Hospital of Obstetrics and Gynecology, Tianjin, China.
Insights
This study developed a predictive model for early-onset preeclampsia with fetal growth restriction (FGR) using first-trimester maternal factors. The model combines mean arterial pressure, uterine artery Doppler, and serum biomarkers for early diagnosis.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Biomarker Research
Background:
- Early-onset preeclampsia with fetal growth restriction (FGR) poses significant risks to maternal and fetal well-being.
- Accurate early diagnosis in the first trimester is crucial for timely intervention and improved outcomes.
Purpose of the Study:
- To develop and evaluate a predictive model for early-onset preeclampsia with FGR.
- To identify key maternal serum biomarkers and biophysical markers for early detection.
Main Methods:
- Retrospective cohort study of 4453 pregnant women.
- Analysis of first-trimester maternal serum levels of PAPP-A, PLGF, PP13, and sEng.
- Inclusion of mean arterial pressure (MAP) and uterine artery Doppler measurements.
Main Results:
- The predictive model achieved a diagnosis rate of 67.4% for early-onset preeclampsia with FGR at a 5% false positive rate.
- The model's diagnostic performance increased to 73.2% at a 10% false positive rate.
- The combined model incorporating MAP, Doppler, and biomarkers demonstrated predictive value.
Conclusions:
- A predictive model combining maternal serum biomarkers, MAP, and uterine artery Doppler can aid in the early diagnosis of early-onset preeclampsia with FGR.
- This model offers potential for improved screening in the first trimester (11-14 weeks gestation).
- Further validation is warranted to confirm its clinical utility.
Abstract:
The aim of the present study was to determine a predictive model for early-onset preeclampsia with fetal growth restriction (FGR) to be used at 11+0 to 13+6 gestational weeks, by combining the maternal serum level of pregnancy-associated plasma protein-A (PAPP-A), placental growth factor (PLGF), placental protein 13 (PP13), soluble endoglin (sEng), mean arterial pressure (MAP), and uterine artery Doppler. This was a retrospective cohort study of 4453 pregnant women. Uterine artery Doppler examination was conducted in the first trimester. Maternal serum PAPP-A, PLGF, PP13, and sEng were measured. Mean arterial pressure was obtained. Women were classified as with/without early-onset preeclampsia, and women with preeclampsia were classified as with/without FGR. Receiver operating characteristic analysis was performed to determine the value of the model. There were 30 and 32 pregnant women with early-onset preeclampsia with and without FGR. The diagnosis rate of early-onset preeclampsia with FGR was 67.4% using the predictive model when the false positive rate was set at 5% and 73.2% when the false positive rate was 10%. The predictive model (MAP, uterine artery Doppler measurements, and serum biomarkers) had some predictive value for the early diagnosis (11+0 to 13+6 gestational weeks) of early-onset preeclampsia with FGR.
