New Predictive Model at 11+0 to 13+6 Gestational Weeks for Early-Onset Preeclampsia With Fetal Growth Restriction

Reprod Sci. 2017 May;24(5):783-789. doi: 10.1177/1933719116669053. Epub 2016 Sep 27.

Abstract

The aim of the present study was to determine a predictive model for early-onset preeclampsia with fetal growth restriction (FGR) to be used at 11+0 to 13+6 gestational weeks, by combining the maternal serum level of pregnancy-associated plasma protein-A (PAPP-A), placental growth factor (PLGF), placental protein 13 (PP13), soluble endoglin (sEng), mean arterial pressure (MAP), and uterine artery Doppler. This was a retrospective cohort study of 4453 pregnant women. Uterine artery Doppler examination was conducted in the first trimester. Maternal serum PAPP-A, PLGF, PP13, and sEng were measured. Mean arterial pressure was obtained. Women were classified as with/without early-onset preeclampsia, and women with preeclampsia were classified as with/without FGR. Receiver operating characteristic analysis was performed to determine the value of the model. There were 30 and 32 pregnant women with early-onset preeclampsia with and without FGR. The diagnosis rate of early-onset preeclampsia with FGR was 67.4% using the predictive model when the false positive rate was set at 5% and 73.2% when the false positive rate was 10%. The predictive model (MAP, uterine artery Doppler measurements, and serum biomarkers) had some predictive value for the early diagnosis (11+0 to 13+6 gestational weeks) of early-onset preeclampsia with FGR.

Keywords: early-onset preeclampsia; fetal growth restriction; first trimester; predictive model.

MeSH terms

  • Adult
  • Arterial Pressure
  • Biomarkers / metabolism
  • Endoglin / blood
  • Female
  • Fetal Growth Retardation / blood
  • Fetal Growth Retardation / diagnosis*
  • Fetal Growth Retardation / physiopathology
  • Galectins / blood
  • Gestational Age
  • Humans
  • Pre-Eclampsia / blood
  • Pre-Eclampsia / diagnosis*
  • Pre-Eclampsia / physiopathology
  • Pregnancy
  • Pregnancy Proteins / blood
  • Pregnancy-Associated Plasma Protein-A / metabolism
  • ROC Curve
  • Retrospective Studies
  • Ultrasonography, Doppler
  • Uterine Artery / diagnostic imaging

Substances

  • Biomarkers
  • ENG protein, human
  • Endoglin
  • Galectins
  • LGALS13 protein, human
  • Pregnancy Proteins
  • Pregnancy-Associated Plasma Protein-A
  • PAPPA protein, human