Early prediction of preeclampsia and small-for-gestational-age via multi-marker model in Chinese pregnancies: a prospective screening study
Abstract Background Recent evidence suggests early screening of preeclampsia and small-for-gestational-age (SGA) would benefit pregnancies followed by subsequent prophylactic use of aspirin. Multi-marker models have shown capability of predicting preeclampsia and SGA in first trimester. Yet the clin...
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| Format: | Article |
| Language: | English |
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BMC
2019-08-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12884-019-2455-8 |
| _version_ | 1818340967550287872 |
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| author | Jing Zhang Luhao Han Wei Li Qiaobin Chen Jie Lei Min Long Weibin Yang Wenya Li Lizhen Zeng Sifan Zeng |
| author_facet | Jing Zhang Luhao Han Wei Li Qiaobin Chen Jie Lei Min Long Weibin Yang Wenya Li Lizhen Zeng Sifan Zeng |
| author_sort | Jing Zhang |
| collection | DOAJ |
| description | Abstract Background Recent evidence suggests early screening of preeclampsia and small-for-gestational-age (SGA) would benefit pregnancies followed by subsequent prophylactic use of aspirin. Multi-marker models have shown capability of predicting preeclampsia and SGA in first trimester. Yet the clinical feasibility of combined screening model for Chinese pregnancies has not been fully assessed. The aim of this study is to evaluate the applicability of a multi-marker screening model to the prediction of preeclampsia and SGA in first trimester particularly among Chinese population. Methods Three thousand two hundred seventy pregnancies meeting the inclusion criteria took first-trimester screening of preeclampsia and SGA. A prior risk based on maternal characteristics was evaluated, and a posterior risk was assessed by combining prior risk with multiple of median (MoM) values of mean arterial pressure (MAP), serum placental growth factor (PLGF) and pregnancy associated plasma protein A (PAPP-A). Both risks were calculated by Preeclampsia PREDICTOR™ software, Perkin Elmer. Screening performance of prior and posterior risks for early and late preeclampsia by using PREDICTOR software was shown by Receiver Operating Characteristics (ROC) curves. The estimation of detection rates and false positive rates of delivery with both preeclampsia and SGA was made. Results Eight cases developed early preeclampsia (0.24%) and 35 were diagnosed as late preeclampsia (1.07%). Five with early preeclampsia and ten with late preeclampsia later delivered SGA newborns (0.46%); 84 without preeclampsia gave birth to the SGAs (2.57%). According to ROC curves, posterior risks performed better than prior risks in terms of preeclampsia, especially in early preeclampsia. At 10% false positive rate, detection rates of early and late preeclampsia were 87.50 and 48.57%, detection rates of early and late SGA were 41.67 and 28.00%, respectively. For SGA, detection rates in cases with preeclampsia were much higher than those in absence of it. Conclusions This study demonstrates that combined screening model could be useful for predicting early preeclampsia in Chinese pregnancies. Furthermore, the performance of SGA screening by same protocol is strongly associated with preeclampsia. |
| first_indexed | 2024-12-13T15:51:19Z |
| format | Article |
| id | doaj.art-266eb251aef542d8a02739221d68060f |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-13T15:51:19Z |
| publishDate | 2019-08-01 |
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| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-266eb251aef542d8a02739221d68060f2022-12-21T23:39:28ZengBMCBMC Pregnancy and Childbirth1471-23932019-08-0119111010.1186/s12884-019-2455-8Early prediction of preeclampsia and small-for-gestational-age via multi-marker model in Chinese pregnancies: a prospective screening studyJing Zhang0Luhao Han1Wei Li2Qiaobin Chen3Jie Lei4Min Long5Weibin Yang6Wenya Li7Lizhen Zeng8Sifan Zeng9Department of Clinical Laboratory, Shenzhen Nanshan Maternity and Child Healthcare HospitalDepartment of Clinical Laboratory, Shenzhen Nanshan Maternity and Child Healthcare HospitalDepartment of Clinical Laboratory, Shenzhen Nanshan Maternity and Child Healthcare HospitalDepartment of Clinical Laboratory, Shenzhen Nanshan Maternity and Child Healthcare HospitalDepartment of Clinical Laboratory, Shenzhen Nanshan Maternity and Child Healthcare HospitalDepartment of Clinical Laboratory, Shenzhen Nanshan Maternity and Child Healthcare HospitalDepartment of Clinical Laboratory, Shenzhen Nanshan Maternity and Child Healthcare HospitalDepartment of Clinical Laboratory, Shenzhen Nanshan Maternity and Child Healthcare HospitalDepartment of Clinical Laboratory, Shenzhen Nanshan Maternity and Child Healthcare HospitalDepartment of Clinical Laboratory, Shenzhen Nanshan Maternity and Child Healthcare HospitalAbstract Background Recent evidence suggests early screening of preeclampsia and small-for-gestational-age (SGA) would benefit pregnancies followed by subsequent prophylactic use of aspirin. Multi-marker models have shown capability of predicting preeclampsia and SGA in first trimester. Yet the clinical feasibility of combined screening model for Chinese pregnancies has not been fully assessed. The aim of this study is to evaluate the applicability of a multi-marker screening model to the prediction of preeclampsia and SGA in first trimester particularly among Chinese population. Methods Three thousand two hundred seventy pregnancies meeting the inclusion criteria took first-trimester screening of preeclampsia and SGA. A prior risk based on maternal characteristics was evaluated, and a posterior risk was assessed by combining prior risk with multiple of median (MoM) values of mean arterial pressure (MAP), serum placental growth factor (PLGF) and pregnancy associated plasma protein A (PAPP-A). Both risks were calculated by Preeclampsia PREDICTOR™ software, Perkin Elmer. Screening performance of prior and posterior risks for early and late preeclampsia by using PREDICTOR software was shown by Receiver Operating Characteristics (ROC) curves. The estimation of detection rates and false positive rates of delivery with both preeclampsia and SGA was made. Results Eight cases developed early preeclampsia (0.24%) and 35 were diagnosed as late preeclampsia (1.07%). Five with early preeclampsia and ten with late preeclampsia later delivered SGA newborns (0.46%); 84 without preeclampsia gave birth to the SGAs (2.57%). According to ROC curves, posterior risks performed better than prior risks in terms of preeclampsia, especially in early preeclampsia. At 10% false positive rate, detection rates of early and late preeclampsia were 87.50 and 48.57%, detection rates of early and late SGA were 41.67 and 28.00%, respectively. For SGA, detection rates in cases with preeclampsia were much higher than those in absence of it. Conclusions This study demonstrates that combined screening model could be useful for predicting early preeclampsia in Chinese pregnancies. Furthermore, the performance of SGA screening by same protocol is strongly associated with preeclampsia.http://link.springer.com/article/10.1186/s12884-019-2455-8ChineseFirst-trimester screeningPreeclampsiaSmall-for-gestational-ageRisk prediction |
| spellingShingle | Jing Zhang Luhao Han Wei Li Qiaobin Chen Jie Lei Min Long Weibin Yang Wenya Li Lizhen Zeng Sifan Zeng Early prediction of preeclampsia and small-for-gestational-age via multi-marker model in Chinese pregnancies: a prospective screening study BMC Pregnancy and Childbirth Chinese First-trimester screening Preeclampsia Small-for-gestational-age Risk prediction |
| title | Early prediction of preeclampsia and small-for-gestational-age via multi-marker model in Chinese pregnancies: a prospective screening study |
| title_full | Early prediction of preeclampsia and small-for-gestational-age via multi-marker model in Chinese pregnancies: a prospective screening study |
| title_fullStr | Early prediction of preeclampsia and small-for-gestational-age via multi-marker model in Chinese pregnancies: a prospective screening study |
| title_full_unstemmed | Early prediction of preeclampsia and small-for-gestational-age via multi-marker model in Chinese pregnancies: a prospective screening study |
| title_short | Early prediction of preeclampsia and small-for-gestational-age via multi-marker model in Chinese pregnancies: a prospective screening study |
| title_sort | early prediction of preeclampsia and small for gestational age via multi marker model in chinese pregnancies a prospective screening study |
| topic | Chinese First-trimester screening Preeclampsia Small-for-gestational-age Risk prediction |
| url | http://link.springer.com/article/10.1186/s12884-019-2455-8 |
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