@article {1876, title = {First trimester maternal serum PIGF, free β-hCG, PAPP-A, PP-13, uterine artery Doppler and maternal history for the prediction of preeclampsia.}, journal = {Placenta}, volume = {33}, year = {2012}, month = {2012 Jun}, pages = {495-501}, abstract = {

OBJECTIVE: To evaluate the detection of pregnancy hypertensive disorders by integrating maternal history, serum biomarkers and uterine artery Doppler in the first trimester.

METHODS: We prospectively recruited 2118 women that underwent an 11-13 weeks aneuploidy screening. We gathered information on maternal history, uterine artery Doppler and serum biomarkers (PAPP-A, PlGF, PP-13 and free β-hCG). Models were developed for the prediction of overall preeclampsia (PE), early-onset PE, late-onset PE and gestational hypertension (GH). For each outcome, we performed a multivariate logistic regression starting from the saturated model: adopting a step-down procedure we excluded all factors not statistically significant (p > 0.05). Sensitivity models only for statistically significant parameters were calculated from the ROC curves for fixed false-positive rates (FPR).

RESULTS: Among 2118 women, 46 (2.17\%) developed GH and 25 (1.18\%) were diagnosed with PE, including 12 (0.57\%) early-onset PE and 13 (0.61\%) late-onset PE. For a fixed FPR of 10 and 5\%, serum PlGF, free β-hCG and chronic hypertension identified respectively 67 and 75\% of women who developed early-onset PE. In the model for the prediction of overall PE the combination of the uterine artery Doppler pulsatility index (UtA PI) with PlGF and chronic hypertension reached a sensitivity of 60\% for a 20\% of FPR.

CONCLUSION: An integration of maternal characteristics and first trimester maternal serum biomarkers (free β-hCG and PlGF) provided a possible screening for early-onset PE. In the overall PE model, UtA PI turned out to be statistically significant but did not improve the detection rate.

}, keywords = {Adult, Biological Markers, Chorionic Gonadotropin, beta Subunit, Human, Cohort Studies, Female, Galectins, Humans, Hypertension, Pregnancy-Induced, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Pregnancy Proteins, Pregnancy Trimester, First, Pregnancy-Associated Plasma Protein-A, Prospective Studies, Ultrasonography, Prenatal, Uterine Artery, Uterus}, issn = {1532-3102}, doi = {10.1016/j.placenta.2012.03.003}, author = {Di Lorenzo, G and Ceccarello, M and Cecotti, V and Ronfani, L and Monasta, L and Vecchi Brumatti, L and Montico, M and D{\textquoteright}Ottavio, G} }