First trimester maternal serum PIGF, free 尾-hCG, PAPP-A, PP-13, uterine artery Doppler and maternal history for the prediction of preeclampsia

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• 作者：G. Di Lorenzo^a ; ^b ; ^{giemmedielle@gmail.com} ; M. Ceccarello^b ; V. Cecotti^a ; L. Ronfani^b ; L. Monasta^b ; L. Vecchi Brumatti^b ; M. Montico^b ; G. D&rsquo ; Ottavio^b
• 关键词：Preeclampsia ; Uterine artery ; PAPP-A ; PlGF ; PP-13 ; Free 尾-hCG
• 刊名：Placenta
• 出版年：2012
• 期刊代码：260_01434004
• 类别：med
• 出版时间：June, 2012
• 卷：33
• 期：6
• 页码：495-501
• 文件大小：182 K

摘要

Objective

To evaluate the detection of pregnancy hypertensive disorders by integrating maternal history, serum biomarkers and uterine artery Doppler in the first trimester.

Methods

We prospectively recruited 2118 women that underwent an 11-13 weeks aneuploidy screening. We gathered information on maternal history, uterine artery Doppler and serum biomarkers (PAPP-A, PlGF, PP-13 and free 尾-hCG). Models were developed for the prediction of overall preeclampsia (PE), early-onset PE, late-onset PE and gestational hypertension (GH). For each outcome, we performed a multivariate logistic regression starting from the saturated model: adopting a step-down procedure we excluded all factors not statistically significant (p聽>聽0.05). Sensitivity models only for statistically significant parameters were calculated from the ROC curves for fixed false-positive rates (FPR).

Results

Among 2118 women, 46 (2.17%) developed GH and 25 (1.18%) were diagnosed with PE, including 12 (0.57%) early-onset PE and 13 (0.61%) late-onset PE. For a fixed FPR of 10 and 5%, serum PlGF, free 尾-hCG and chronic hypertension identified respectively 67 and 75%of women who developed early-onset PE. In the model for the prediction of overall PE the combination of the uterine artery Doppler pulsatility index (UtA PI) with PlGF and chronic hypertension reached a sensitivity of 60%for a 20%of FPR.

Conclusion

An integration of maternal characteristics and first trimester maternal serum biomarkers (free 尾-hCG and PlGF) provided a possible screening for early-onset PE. In the overall PE model, UtA PI turned out to be statistically significant but did not improve the detection rate.