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Comparison of two "a priori" risk assessment algorithms for preeclampsia in Italy: a prospective multicenter study
Daniela Di Martino1, Bianca Masturzo2, Sara Paracchini2
1Department of Woman, Mother and Neonate, Buzzi Children's Hospital, University of Milan, via Castelvetro 32, 20154, Milan, Italy.
Insights
The Fetal Medicine Foundation algorithm demonstrated higher detection rates for early and late preeclampsia in an Italian population. Both the Fetal Medicine Foundation and BCNatal algorithms provided reliable risk assessments for preeclampsia.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Diagnostic Screening
Background:
- Preeclampsia is a significant complication of pregnancy.
- Early and accurate risk assessment for preeclampsia is crucial for timely intervention.
- Existing screening algorithms require validation in diverse populations.
Purpose of the Study:
- To compare the performance of two preeclampsia screening algorithms: the Fetal Medicine Foundation (FMF) 2012 and BCNatal 2013.
- To evaluate these algorithms in an Italian population for pregnancies at 11-13 weeks' gestation.
Main Methods:
- A multicentric prospective study conducted from January 2014 to May 2017.
- Inclusion of 11,632 pregnancies at 11-13 weeks' gestation.
- Utilized two algorithms to calculate the a priori risk of preeclampsia based on medical history.
Main Results:
- The Fetal Medicine Foundation algorithm showed higher detection rates for both early (58.2%) and late (44.1%) preeclampsia compared to BCNatal (41.8% and 38%, respectively) at a 10% false positive rate.
- The study included 11,632 pregnancies, with 0.6% developing early preeclampsia and 1.8% developing late preeclampsia.
- Associated risks for early and late preeclampsia were calculated, with no significant difference between the algorithms (p value ns).
Conclusions:
- The Fetal Medicine Foundation screening algorithm achieved the highest detection rate for both early and late preeclampsia.
- Both FMF and BCNatal algorithms demonstrated similar and reliable a priori risk estimations in the Italian cohort.
- The study confirms the utility of these algorithms for preeclampsia screening in the studied population.
Purpose:
To compare the performance of the algorithms proposed by the Fetal Medicine Foundation in 2012 and BCNatal in 2013 in an Italian population.
Methods:
A multicentric prospective study was carried out which included pregnancies at 11-13 weeks' gestation from Jan 2014 through May 2017. Two previously published algorithms were used for the calculation of the "a priori" risk of preeclampsia (based on risk factors from medical history) in each individual.
Results:
In a study population of 11,632 cases, 67 (0.6%) developed early preeclampsia and 211 (1.8%) developed late preeclampsia. The detection rates (95% CI) for early and late preeclampsia were 58.2% (45.5-70.2) vs. 41.8% (29.6-54.5) (p value < 0.05) and 44.1% (37.3-51.1) vs. 38% (31.3-44.8) (p value < 0.05) for the Fetal Medicine Foundation and BCNatal, respectively (at a 10% false positive rate). The associated risk was 1:226 and 1:198 (p value ns) for early PE, and 1:17 and 1:24 (p value ns) for late PE for the Fetal Medicine Foundation and BCNatal, respectively.
Conclusions:
The Fetal Medicine Foundation screening for preeclampsia at 11-13 weeks' gestation scored the highest detection rate for both early and late PE. At a fixed 10% false positive rate, the estimated "a priori" risks of both the Fetal Medicine Foundation and the BCNatal algorithms in an Italian population were quite similar, and both were reliable and consistent.