%0 Journal Article %J Placenta %D 2012 %T First trimester maternal serum PIGF, free β-hCG, PAPP-A, PP-13, uterine artery Doppler and maternal history for the prediction of preeclampsia. %A Di Lorenzo, G %A Ceccarello, M %A Cecotti, V %A Ronfani, L %A Monasta, L %A Vecchi Brumatti, L %A Montico, M %A D'Ottavio, G %K Adult %K Biological Markers %K Chorionic Gonadotropin, beta Subunit, Human %K Cohort Studies %K Female %K Galectins %K Humans %K Hypertension, Pregnancy-Induced %K Pre-Eclampsia %K Pregnancy %K Pregnancy Complications %K Pregnancy Proteins %K Pregnancy Trimester, First %K Pregnancy-Associated Plasma Protein-A %K Prospective Studies %K Ultrasonography, Prenatal %K Uterine Artery %K Uterus %X

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.

%B Placenta %V 33 %P 495-501 %8 2012 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/22459245?dopt=Abstract %R 10.1016/j.placenta.2012.03.003