Predicting the risk of pre‐eclampsia between 11 and 13 weeks' gestation by combining maternal characteristics and serum analytes, PAPP‐A and free β‐hCG
- 8 October 2010
- journal article
- research article
- Published by Wiley in Prenatal Diagnosis
- Vol. 30 (12-13), 1138-1142
- https://doi.org/10.1002/pd.2627
Abstract
Objective To determine if a simplified model for predicting pre‐eclampsia (PEC) can be developed by combining first‐trimester serum analytes, pregnancy‐associated plasma protein A (PAPP‐A) and free beta human chorionic gonadotrophin (β‐hCG), and maternal characteristics. Methods A retrospective cohort study of patients seen for first‐trimester aneuploidy screening from 2003 to 2009. The 5th, 10th, 90th, and 95th percentiles for the analyte multiples of the medians (MoMs) for our population were determined and evaluated for association with PEC. Univariate and backward stepwise logistic regression analyses were performed and the area under the receiver operating characteristic (ROC) curves [area under curve (AUC)] used to determine the best models for predicting PEC. Results Among 4020 women meeting the inclusion criteria, outcome data was available for 3716 (93%). There were 293 cases of PEC. The final model identified a history of pre‐gestational diabetes [aOR 2.6, 95% confidence interval (CI) 1.7–3.9], chronic hypertension (cHTN) (aOR 2.6, 95% CI 1.7–3.9), maternal body mass index (BMI) > 25 (aOR 2.5, 95% CI 1.9–3.4), African American race (aOR 1.8, 95% CI 1.3–2.6), and PAPP‐A MoM < 10th percentile (aOR 1.6, 95% CI 1.1–2.4) to be significant predictors of PEC (AUC = 0.70, 95% CI 0.65–0.72). Conclusion Low first‐trimester PAPP‐A levels are associated with the development of PEC; however, the model was only modestly efficient in its predictive ability. Copyright © 2010 John Wiley & Sons, Ltd.This publication has 17 references indexed in Scilit:
- Hypertensive disorders in pregnancy: screening by biophysical and biochemical markers at 11–13 weeksUltrasound in Obstetrics & Gynecology, 2010
- First‐trimester ultrasound and biochemical markers of aneuploidy and the prediction of preterm or early preterm deliveryUltrasound in Obstetrics & Gynecology, 2008
- Low levels of maternal serum PAPP‐A in the first trimester and the risk of pre‐eclampsiaPrenatal Diagnosis, 2007
- First‐trimester ADAM12 and PAPP‐A as markers for intrauterine fetal growth restriction through their roles in the insulin‐like growth factor systemPrenatal Diagnosis, 2007
- Prediction of pre‐eclampsia by uterine artery Doppler ultrasonography and maternal serum pregnancy‐associated plasma protein‐A, free β‐human chorionic gonadotropin, activin A and inhibin A at 22 + 0 to 24 + 6 weeks' gestationUltrasound in Obstetrics & Gynecology, 2006
- Predicting complications of pregnancy with first‐trimester maternal serum free‐βhCG, PAPP‐A and inhibin‐APrenatal Diagnosis, 2003
- Decreased first trimester PAPP‐A is a predictor of adverse pregnancy outcomePrenatal Diagnosis, 2002
- Early Pregnancy Levels of Pregnancy-Associated Plasma Protein A and the Risk of Intrauterine Growth Restriction, Premature Birth, Preeclampsia, and StillbirthJournal of Clinical Endocrinology & Metabolism, 2002
- First trimester maternal serum free β human chorionic gonadotrophin and pregnancy associated plasma protein A as predictors of pregnancy complicationsBJOG: An International Journal of Obstetrics and Gynaecology, 2000
- Role of the IGF system in trophoblast invasion and pre-eclampsia.Human Reproduction, 1999