Quality assessment of first-trimester screening for preterm pre-eclampsia

Area of Science:

• Maternal-fetal medicine
• Obstetrics
• Perinatal screening

Background:

• Preterm pre-eclampsia poses significant risks to maternal and fetal well-being.
• Early screening and intervention are crucial for improving pregnancy outcomes.
• First-trimester screening models integrate multiple risk factors for prediction.

Purpose of the Study:

• To evaluate the performance and impact of first-trimester preterm pre-eclampsia screening.
• To assess the feasibility of estimating screening performance in a single-center setting.
• To determine the potential impact of screening on the prevalence of preterm pre-eclampsia.

Main Methods:

• Prospective single-center study involving singleton pregnancies.
• Screening utilized maternal characteristics, mean arterial pressure (MAP), uterine artery Doppler, PAPP-A, and PlGF.
• Risk assessment followed a published model; high-risk individuals received low-dose aspirin prophylaxis.

Main Results:

• The screening model's parameters were consistent with observed data.
• Estimated detection rate was 79.7% with a 16.2% false-positive rate.
• Six cases of preterm pre-eclampsia occurred; four in screen-positive women. Prevalence was 62% of expected, but the study was underpowered to confirm impact.

Conclusions:

• Single-center estimation of preterm pre-eclampsia screening performance is feasible with <2000 women.
• A significantly larger cohort is necessary to reliably assess the impact of screening on prevalence.
• Further research with larger sample sizes is warranted to validate screening effectiveness.