Pregnancy hypertension · 2025
Modified multiple marker aneuploidy screening as a primary screening test for preeclampsia: A validation study.
СтатьяВалидационное исследованиеНазвание и аннотация: Перевод в очереди
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Huang Tianhua, Rashid Shamim, Wang Yanbo George, Woo Rachel S, Priston Megan, Gibbons Clare, Bedford Melanie, Mei-Dan Elad
Аннотация
OBJECTIVES: Our previous case-controlled study indicates that the combination of maternal characteristics, serum placental growth factor (PlGF), and pregnancy-associated plasma protein A (PAPP-A) can predict early-onset and preterm preeclampsia with reasonable accuracy. This study aims to validate whether our preeclampsia screening algorithm can be applied to a large general obstetric population by using serum markers obtained from routine aneuploidy screening.
STUDY DESIGN: This retrospective cohort study analyzed maternal characteristics, serum markers, and pregnancy outcomes from pregnant individuals who underwent enhanced first-trimester screening and delivered at a Toronto tertiary center between December 2017 and June 2021.
MAIN OUTCOME MEASURES: Logistic regression was used to assess prediction accuracy and compare screening performance with algorithm from our previous case-control study. The multiple of the median (MoM) of serum markers were compared between cases and controls using Mann-Whitney U tests.
RESULTS: The study included 340 preeclampsia cases (15 delivered < 34 weeks, 77 delivered < 37 weeks and 263 delivered ≥ 37 weeks) and 10,145 controls. Preeclampsia cases had significantly lower MoM of PlGF (0.83 vs 1.02) and PAPP-A (0.89 vs 1.07) (p < 0.0001 for both). At a 20 % false-positive rate, 80 % of early-onset, 68 % of preterm, and 58 % of term preeclampsia cases could be predicted using maternal characteristics and serum markers. Applying our previously developed algorithm achieved a comparable accuracy in this population.
CONCLUSION: Our findings support expanding multiple marker aneuploidy screening to include accurate, cost-effective preeclampsia risk prediction, enabling early intervention for high-risk pregnant individuals.
STUDY DESIGN: This retrospective cohort study analyzed maternal characteristics, serum markers, and pregnancy outcomes from pregnant individuals who underwent enhanced first-trimester screening and delivered at a Toronto tertiary center between December 2017 and June 2021.
MAIN OUTCOME MEASURES: Logistic regression was used to assess prediction accuracy and compare screening performance with algorithm from our previous case-control study. The multiple of the median (MoM) of serum markers were compared between cases and controls using Mann-Whitney U tests.
RESULTS: The study included 340 preeclampsia cases (15 delivered < 34 weeks, 77 delivered < 37 weeks and 263 delivered ≥ 37 weeks) and 10,145 controls. Preeclampsia cases had significantly lower MoM of PlGF (0.83 vs 1.02) and PAPP-A (0.89 vs 1.07) (p < 0.0001 for both). At a 20 % false-positive rate, 80 % of early-onset, 68 % of preterm, and 58 % of term preeclampsia cases could be predicted using maternal characteristics and serum markers. Applying our previously developed algorithm achieved a comparable accuracy in this population.
CONCLUSION: Our findings support expanding multiple marker aneuploidy screening to include accurate, cost-effective preeclampsia risk prediction, enabling early intervention for high-risk pregnant individuals.