Routine first-trimester combined screening for pre-eclampsia: pregnancy-associated plasma protein-A or placental growth factor?
Adult
Algorithms
Biomarkers
/ blood
Down Syndrome
/ diagnosis
Female
Gestational Age
Humans
Infant, Newborn
Infant, Small for Gestational Age
/ blood
Nuchal Translucency Measurement
Placenta Growth Factor
/ blood
Pre-Eclampsia
/ diagnosis
Pregnancy
Pregnancy Trimester, First
/ blood
Pregnancy-Associated Plasma Protein-A
/ analysis
Prenatal Diagnosis
/ methods
Pulsatile Flow
ROC Curve
Retrospective Studies
Risk Assessment
/ methods
Uterine Artery
PAPP-A
PlGF
blood pressure
first trimester
pre-eclampsia
screening
small-for-gestational age
trisomy 21
uterine artery Doppler
Journal
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
ISSN: 1469-0705
Titre abrégé: Ultrasound Obstet Gynecol
Pays: England
ID NLM: 9108340
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
revised:
18
04
2021
received:
21
01
2021
accepted:
30
04
2021
pubmed:
18
5
2021
medline:
15
12
2021
entrez:
17
5
2021
Statut:
ppublish
Résumé
To compare the screening performance of serum pregnancy-associated plasma protein-A (PAPP-A) vs placental growth factor (PlGF) in routine first-trimester combined screening for pre-eclampsia (PE), small-for-gestational age (SGA) at birth and trisomy 21. This was a retrospective study nested in pregnancy cohorts undergoing first-trimester combined screening for PE and trisomy 21 using The Fetal Medicine Foundation (FMF) algorithm based on maternal characteristics, nuchal translucency thickness, PAPP-A, free beta-human chorionic gonadotropin, blood pressure and uterine artery Doppler. Women at high risk for preterm PE (≥ 1 in 50) received 150 mg of aspirin per day, underwent serial fetal growth scans at 28 and 36 weeks and were offered elective birth from 40 weeks of gestation. PlGF was quantified retrospectively from stored surplus first-trimester serum samples. The performance of combined first-trimester screening for PE and SGA using maternal history, blood pressure, uterine artery pulsatility index and either PAPP-A or PlGF was calculated. Similarly, the performance of combined first-trimester screening for trisomy 21 was calculated using either PAPP-A or PlGF in addition to maternal age, nuchal translucency thickness and free beta-human chorionic gonadotropin. Maternal serum PAPP-A was assayed in 1094 women, including 82 with PE, 111 with SGA (birth weight < 10 Using either PlGF or PAPP-A in routine first-trimester combined screening based on maternal characteristics, blood pressure and uterine artery Doppler does not make a significant clinical difference to the detection of PE or SGA. Depending on the setting, biomarkers should be chosen to achieve a good compromise between performance and measurement requirements. This pragmatic clinical-effectiveness study suggests that combined screening for PE can be implemented successfully in a public healthcare setting without changing current protocols for the assessment of PAPP-A in the first trimester. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Substances chimiques
Biomarkers
0
PGF protein, human
0
Placenta Growth Factor
144589-93-5
Pregnancy-Associated Plasma Protein-A
EC 3.4.24.-
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
540-545Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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