Modified multiple marker aneuploidy screening as a primary screening test for preeclampsia.

Area of Science:

• Maternal-fetal medicine
• Biochemical screening
• Pregnancy outcomes

Background:

• Abnormal maternal biochemical markers are linked to adverse pregnancy outcomes.
• This study investigates using maternal characteristics and biochemical markers for preeclampsia (PE) screening.
• A secondary aim is to identify risks for gestational hypertension and preterm birth.

Purpose of the Study:

• To assess the efficacy of combining maternal characteristics with first and second-trimester biochemical markers for preeclampsia (PE) screening.
• To evaluate this combined approach for identifying pregnancies at risk of gestational hypertension and preterm birth.

Main Methods:

• A case-control study analyzed maternal characteristics and biochemical markers (PAPP-A, PlGF, hCG, AFP, uE3, Inhibin A) from blood samples.
• Median multiples of the median (MoM) were compared between cases (PE, gestational hypertension, preterm birth) and controls.
• Logistic regression estimated screening performance (detection rate and false positive rate).

Main Results:

• PE cases showed significantly lower first-trimester PAPP-A, PlGF, and hCG MoM compared to controls.
• First-trimester PAPP-A, PlGF, and hCG were lowest in preterm and early-onset PE.
• A combination of maternal characteristics with first-trimester PAPP-A and PlGF predicted 67% of preterm PE and 76% of early-onset PE at a 20% false positive rate.

Conclusions:

• Maternal characteristics combined with first-trimester PAPP-A and PlGF offer reasonable accuracy for identifying women at risk of early-onset PE.
• This combination allows for the triage of high-risk pregnancies for further investigation and risk-reducing therapy.
• The predictive accuracy for gestational hypertension and preterm birth was lower with this screening approach.