Biophysical Markers of Suspected Preeclampsia, Fetal Growth Restriction and The Two Combined—How Accurate They Are?
Objectives—To conduct a secondary analysis of prediction accuracy of biophysical markers for suspected Preeclampsia (PE), Fetal Growth Restriction (FGR) and the two combined near delivery in a Slovenian cohort. Methods—This was a secondary analysis of a database of a total 125 Slovenian pregnant wom...
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MDPI AG
2022-04-01
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| Series: | Reproductive Medicine |
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| Online Access: | https://www.mdpi.com/2673-3897/3/2/7 |
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| author | Adi Sharabi-Nov Nataša Tul Kristina Kumer Tanja Premru Sršen Vesna Fabjan Vodušek Teja Fabjan Josko Osredkar Kypros H. Nicolaides Hamutal Meiri |
| author_facet | Adi Sharabi-Nov Nataša Tul Kristina Kumer Tanja Premru Sršen Vesna Fabjan Vodušek Teja Fabjan Josko Osredkar Kypros H. Nicolaides Hamutal Meiri |
| author_sort | Adi Sharabi-Nov |
| collection | DOAJ |
| description | Objectives—To conduct a secondary analysis of prediction accuracy of biophysical markers for suspected Preeclampsia (PE), Fetal Growth Restriction (FGR) and the two combined near delivery in a Slovenian cohort. Methods—This was a secondary analysis of a database of a total 125 Slovenian pregnant women attending a high-risk pregnancy clinic due to suspected PE (<i>n</i> = 31), FGR (<i>n</i> = 16) and PE + FGR (<i>n</i> = 42) from 28–39 weeks gestation and their corresponding term (<i>n</i> = 21) and preterm (PTD, <i>n</i> = 15) controls. Data for Mean Arterial blood Pressure (MAP) and Uterine artery pulsatility index (UtA PI) estimated by Doppler sonography were extracted from the database of patients who were tested at admission to the high-risk clinic with the suspected complications. The reactive hyperemia index (RHI), and the Augmentation Index (AIX%) were extracted from the patient database using measured values obtained with the assistance of the Endo PAT, a device set to measure the signal of the peripheral arterial tone (PAT) from the blood vessels endothelium. Linear regression coefficients, Box and Whisker plots, Area under the Curve (AUC) of receiver Operation Characteristic (ROC) curves, and multiple regression were used to assess the marker accuracy using detection rate (DR) and false-positive rate (FPR) and previously reported cut-offs for estimating the positive and negative predictive value (NPV and PPV). The SPSS non-parametric statistics (Kruskal Wallis and Mann–Whitney) and Spearman’s regression coefficient were used to assess marker accuracy; <i>p</i> < 0.05 was considered significant. Results—MAP values reached diagnostic accuracy (AUC = 1.00, DR = 100%) for early PE cases delivered < 34, whereas UtA Doppler PI values yielded such results for early FGR < 34 weeks and the two combined reached such accuracy for PE + FGR. To reach diagnostic accuracy for all cases of the complications, the Endo PAT markers with values for MAP and UtA Doppler PI were required for cases near delivery. Multiple regression analyses showed added value for advanced maternal age and gestational week in risk assessment for all cases of PE, FGR, and PE + FGR. Spearman’s regression coefficient yielded r > 0.6 for UtA Doppler PI over GA for PE and FGR, whereas for RHI over BMI, the regression coefficient was r > 0.5 (<i>p</i> < 0.001 for each). Very high correlations were also found between UtA Doppler PI and sFlt-1/PlGF or PlGF (r = −0.495, <i>p</i> < 0.001), especially in cases of FGR. Conclusion—The classical biophysical markers MAP and UtA Doppler PI provided diagnostic accuracy for PE and FGR < 34 wks gestation. A multiple biophysical marker analysis was required to reach diagnostic accuracy for all cases of these complications. The UtA Doppler PI and maternal serum sFlt-1/PlGF or PlGF were equally accurate for early cases to enable the choice of the markers for the clinical use according to the more accessible method. |
| first_indexed | 2024-03-09T22:35:04Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2673-3897 |
| language | English |
| last_indexed | 2024-03-09T22:35:04Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Reproductive Medicine |
| spelling | doaj.art-b1577b29eca7433c9740db7551b50a412023-11-23T18:49:40ZengMDPI AGReproductive Medicine2673-38972022-04-0132628410.3390/reprodmed3020007Biophysical Markers of Suspected Preeclampsia, Fetal Growth Restriction and The Two Combined—How Accurate They Are?Adi Sharabi-Nov0Nataša Tul1Kristina Kumer2Tanja Premru Sršen3Vesna Fabjan Vodušek4Teja Fabjan5Josko Osredkar6Kypros H. Nicolaides7Hamutal Meiri8Ziv Medical Center, Safed and Tel Hai College, Tel Hai 13100, IsraelFaculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, SloveniaInstitute of Clinical Chemistry and Biochemistry, University Medical Centre, Njegoševa 4, 1000 Ljubljana, SloveniaFaculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, SloveniaDepartment of Perinatology, Division of Obstetrics and Gynecology, University Medical Center, Zaloška Cesta 2, 1000 Ljubljana, SloveniaInstitute of Clinical Chemistry and Biochemistry, University Medical Centre, Njegoševa 4, 1000 Ljubljana, SloveniaFaculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, SloveniaThe Fetal Medicine Research Institute, King’s College Hospital, 16-20 Windsor Walk, London SE5 8BB, UKTeleMarpe Ltd., 41 Beit El St., Tel Aviv 6908742, IsraelObjectives—To conduct a secondary analysis of prediction accuracy of biophysical markers for suspected Preeclampsia (PE), Fetal Growth Restriction (FGR) and the two combined near delivery in a Slovenian cohort. Methods—This was a secondary analysis of a database of a total 125 Slovenian pregnant women attending a high-risk pregnancy clinic due to suspected PE (<i>n</i> = 31), FGR (<i>n</i> = 16) and PE + FGR (<i>n</i> = 42) from 28–39 weeks gestation and their corresponding term (<i>n</i> = 21) and preterm (PTD, <i>n</i> = 15) controls. Data for Mean Arterial blood Pressure (MAP) and Uterine artery pulsatility index (UtA PI) estimated by Doppler sonography were extracted from the database of patients who were tested at admission to the high-risk clinic with the suspected complications. The reactive hyperemia index (RHI), and the Augmentation Index (AIX%) were extracted from the patient database using measured values obtained with the assistance of the Endo PAT, a device set to measure the signal of the peripheral arterial tone (PAT) from the blood vessels endothelium. Linear regression coefficients, Box and Whisker plots, Area under the Curve (AUC) of receiver Operation Characteristic (ROC) curves, and multiple regression were used to assess the marker accuracy using detection rate (DR) and false-positive rate (FPR) and previously reported cut-offs for estimating the positive and negative predictive value (NPV and PPV). The SPSS non-parametric statistics (Kruskal Wallis and Mann–Whitney) and Spearman’s regression coefficient were used to assess marker accuracy; <i>p</i> < 0.05 was considered significant. Results—MAP values reached diagnostic accuracy (AUC = 1.00, DR = 100%) for early PE cases delivered < 34, whereas UtA Doppler PI values yielded such results for early FGR < 34 weeks and the two combined reached such accuracy for PE + FGR. To reach diagnostic accuracy for all cases of the complications, the Endo PAT markers with values for MAP and UtA Doppler PI were required for cases near delivery. Multiple regression analyses showed added value for advanced maternal age and gestational week in risk assessment for all cases of PE, FGR, and PE + FGR. Spearman’s regression coefficient yielded r > 0.6 for UtA Doppler PI over GA for PE and FGR, whereas for RHI over BMI, the regression coefficient was r > 0.5 (<i>p</i> < 0.001 for each). Very high correlations were also found between UtA Doppler PI and sFlt-1/PlGF or PlGF (r = −0.495, <i>p</i> < 0.001), especially in cases of FGR. Conclusion—The classical biophysical markers MAP and UtA Doppler PI provided diagnostic accuracy for PE and FGR < 34 wks gestation. A multiple biophysical marker analysis was required to reach diagnostic accuracy for all cases of these complications. The UtA Doppler PI and maternal serum sFlt-1/PlGF or PlGF were equally accurate for early cases to enable the choice of the markers for the clinical use according to the more accessible method.https://www.mdpi.com/2673-3897/3/2/7preeclampsiaMAP—mean arterial blood pressure (mm Hg)PI—uterine artery pulsatility indexRHI—reactive hyperemia indexAIX (%)—augmentation index (percent)Endo PAT |
| spellingShingle | Adi Sharabi-Nov Nataša Tul Kristina Kumer Tanja Premru Sršen Vesna Fabjan Vodušek Teja Fabjan Josko Osredkar Kypros H. Nicolaides Hamutal Meiri Biophysical Markers of Suspected Preeclampsia, Fetal Growth Restriction and The Two Combined—How Accurate They Are? Reproductive Medicine preeclampsia MAP—mean arterial blood pressure (mm Hg) PI—uterine artery pulsatility index RHI—reactive hyperemia index AIX (%)—augmentation index (percent) Endo PAT |
| title | Biophysical Markers of Suspected Preeclampsia, Fetal Growth Restriction and The Two Combined—How Accurate They Are? |
| title_full | Biophysical Markers of Suspected Preeclampsia, Fetal Growth Restriction and The Two Combined—How Accurate They Are? |
| title_fullStr | Biophysical Markers of Suspected Preeclampsia, Fetal Growth Restriction and The Two Combined—How Accurate They Are? |
| title_full_unstemmed | Biophysical Markers of Suspected Preeclampsia, Fetal Growth Restriction and The Two Combined—How Accurate They Are? |
| title_short | Biophysical Markers of Suspected Preeclampsia, Fetal Growth Restriction and The Two Combined—How Accurate They Are? |
| title_sort | biophysical markers of suspected preeclampsia fetal growth restriction and the two combined how accurate they are |
| topic | preeclampsia MAP—mean arterial blood pressure (mm Hg) PI—uterine artery pulsatility index RHI—reactive hyperemia index AIX (%)—augmentation index (percent) Endo PAT |
| url | https://www.mdpi.com/2673-3897/3/2/7 |
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