First-trimester pre-eclampsia biomarker profiles in Asian population: multicenter cohort study

Area of Science:

• Maternal-fetal medicine
• Biomarker research
• Population-specific risk assessment

Background:

• Preterm pre-eclampsia (PE) risk assessment relies on biomarker multiples of the median (MoM) derived from European populations.
• Applicability of these European-derived formulae to diverse Asian populations is not well-established.
• Quality assurance (QA) of biomarker measurements is crucial for reliable screening.

Purpose of the Study:

• To evaluate European-derived biomarker MoM formulae for preterm PE risk assessment in seven Asian populations.
• To conduct a quality assurance (QA) assessment of biomarker measurements.
• To establish criteria for ongoing QA of biomarker measurements.

Main Methods:

• Prospective, multicenter study of 4023 singleton pregnancies (11-13+6 weeks gestation) across 11 Asian centers.
• Measurement of mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), and placental growth factor (PlGF).
• Transformation of measurements into MoM values using established Fetal Medicine Foundation (FMF) formulae and evaluation of variations and QA.

Main Results:

• Asian populations showed approximately 4% lower MAP MoM and 11% lower PlGF MoM compared to European-derived expectations.
• UtA-PI MoM values were similar, but PlGF MoM values were significantly higher (37%) in a South Asian subgroup.
• Consistent deviations in MAP and PlGF MoM values were observed across centers, highlighting the need for QA.

Conclusions:

• European-derived formulae for preterm PE screening require adjustment for Asian populations due to anthropometric differences.
• Development of Asian-specific formulae for biomarker MoM calculation is necessary for accurate patient-specific risk prediction.
• Regular quality assessment of biomarker measurements is essential for reliable screening.