Performance of a first-trimester screening of preeclampsia in a routine care low-risk setting

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• 作者：Elena Scazzocchio ; MD^a ; ^b ; Francesc Figueras ; PhD^a ; ^{ffiguera@clinic.ub.es} ; Fatima Crispi ; PhD^a ; Eva Meler ; MD^a ; ^b ; Narcí ; s Masoller ; MD^a ; Raquel Mula ; MD^a ; Eduard Gratacos ; PhD^a
• 关键词：blood pressure ; preeclampsia ; screening ; uterine artery Doppler
• 刊名：American Journal of Obstetrics and Gynecology
• 出版年：2013
• 出版时间：March, 2013
• 年：2013
• 卷：208
• 期：3
• 页码：203.e1-203.e10
• 全文大小：1357 K

文摘

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Objective

We sought to evaluate the effectiveness of an integrated first-trimester screening test to predict preeclampsia (PE).

Study Design

A prospective cohort of singleton pregnancies underwent routine first-trimester screening from 2009 through 2011 (n = 5759). A logistic regression-based predictive model for early- and late-onset PE was constructed based on: maternal characteristics; levels of pregnancy-associated plasma protein-A and free ¦Â-human chorionic gonadotropin at 8-12 weeks; and blood pressure and uterine artery Doppler at 11.0-13.6 weeks.

Results

Of the 5170 enrolled participants, 136 (2.6 % ) developed PE (early PE: 26 [0.5 % ]; late PE: 110 [2.1 % ]). At 5 % and 10 % false-positive rates, detection rates were 69.2 % and 80.8 % for early PE (area under the curve, 0.95; 95 % confidence interval, 0.94-0.98) and 29.4 % and 39.6 % for late PE (area under the curve, 0.71; 95 % confidence interval, 0.66-0.76), respectively.

Conclusion

First-trimester screening combining maternal factors with uterine artery Doppler, blood pressure, and pregnancy-associated plasma protein-A is useful to predict PE in a routine care setting.