Prospective Validation of First-Trimester Screening for Preterm Preeclampsia in Nulliparous Women (PREDICTION Study).

hypertension pre-eclampsia pregnancy premature birth risk factors

Journal

Hypertension (Dallas, Tex. : 1979)
ISSN: 1524-4563
Titre abrégé: Hypertension
Pays: United States
ID NLM: 7906255

Informations de publication

Date de publication:
06 May 2024
Historique:
medline: 6 5 2024
pubmed: 6 5 2024
entrez: 6 5 2024
Statut: aheadofprint

Résumé

Fetal Medicine Foundation (FMF) studies suggest that preterm preeclampsia can be predicted in the first trimester by combining biophysical, biochemical, and ultrasound markers and prevented using aspirin. We aimed to evaluate the FMF preterm preeclampsia screening test in nulliparous women. We conducted a prospective multicenter cohort study of nulliparous women recruited at 11 to 14 weeks. Maternal characteristics, mean arterial blood pressure, PAPP-A (pregnancy-associated plasma protein A), PlGF (placental growth factor) in maternal blood, and uterine artery pulsatility index were collected at recruitment. The risk of preterm preeclampsia was calculated by a third party blinded to pregnancy outcomes. Receiver operating characteristic curves were used to estimate the detection rate (sensitivity) and the false-positive rate (1-specificity) for preterm (<37 weeks) and for early-onset (<34 weeks) preeclampsia according to the FMF screening test and according to the American College of Obstetricians and Gynecologists criteria. We recruited 7554 participants including 7325 (97%) who remained eligible after 20 weeks of which 65 (0.9%) developed preterm preeclampsia, and 22 (0.3%) developed early-onset preeclampsia. Using the FMF algorithm (cutoff of ≥1 in 110 for preterm preeclampsia), the detection rate was 63.1% for preterm preeclampsia and 77.3% for early-onset preeclampsia at a false-positive rate of 15.8%. Using the American College of Obstetricians and Gynecologists criteria, the equivalent detection rates would have been 61.5% and 59.1%, respectively, for a false-positive rate of 34.3%. The first-trimester FMF preeclampsia screening test predicts two-thirds of preterm preeclampsia and three-quarters of early-onset preeclampsia in nulliparous women, with a false-positive rate of ≈16%. URL: https://www.clinicaltrials.gov; Unique identifier: NCT02189148.

Sections du résumé

BACKGROUND UNASSIGNED
Fetal Medicine Foundation (FMF) studies suggest that preterm preeclampsia can be predicted in the first trimester by combining biophysical, biochemical, and ultrasound markers and prevented using aspirin. We aimed to evaluate the FMF preterm preeclampsia screening test in nulliparous women.
METHODS UNASSIGNED
We conducted a prospective multicenter cohort study of nulliparous women recruited at 11 to 14 weeks. Maternal characteristics, mean arterial blood pressure, PAPP-A (pregnancy-associated plasma protein A), PlGF (placental growth factor) in maternal blood, and uterine artery pulsatility index were collected at recruitment. The risk of preterm preeclampsia was calculated by a third party blinded to pregnancy outcomes. Receiver operating characteristic curves were used to estimate the detection rate (sensitivity) and the false-positive rate (1-specificity) for preterm (<37 weeks) and for early-onset (<34 weeks) preeclampsia according to the FMF screening test and according to the American College of Obstetricians and Gynecologists criteria.
RESULTS UNASSIGNED
We recruited 7554 participants including 7325 (97%) who remained eligible after 20 weeks of which 65 (0.9%) developed preterm preeclampsia, and 22 (0.3%) developed early-onset preeclampsia. Using the FMF algorithm (cutoff of ≥1 in 110 for preterm preeclampsia), the detection rate was 63.1% for preterm preeclampsia and 77.3% for early-onset preeclampsia at a false-positive rate of 15.8%. Using the American College of Obstetricians and Gynecologists criteria, the equivalent detection rates would have been 61.5% and 59.1%, respectively, for a false-positive rate of 34.3%.
CONCLUSIONS UNASSIGNED
The first-trimester FMF preeclampsia screening test predicts two-thirds of preterm preeclampsia and three-quarters of early-onset preeclampsia in nulliparous women, with a false-positive rate of ≈16%.
REGISTRATION UNASSIGNED
URL: https://www.clinicaltrials.gov; Unique identifier: NCT02189148.

Identifiants

DOI: 10.1161/HYPERTENSIONAHA.123.22584 PMID: 38708601
pubmed: 38708601
doi: 10.1161/HYPERTENSIONAHA.123.22584
doi:

Banques de données

ClinicalTrials.gov
['NCT02189148']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Auteurs

Paul Guerby (P)

Reproduction, Mother and Child Health Unit, CHU De Québec-Université Laval Research Center, Université Laval, Canada. (P.G., Y.G., J.-C.F., N.C., L.G., E.B.).
Department of Gynecology and Obstetrics, Infinity CNRS, Inserm UMR 1291, CHU Toulouse, France (P.G.).

Francois Audibert (F)

Department of Obstetrics and Gynecology, CHU Ste-Justine Research Center, Université de Montréal, Canada (F.A.).
ORCID: 0000-0002-2697-3826

Jo-Ann Johnson (JA)

Department of Obstetrics and Gynaecology, University of Calgary, AB, Canada (J.-A.J.).

Nanette Okun (N)

Department of Obstetrics and Gynaecology, University of Toronto, ON, Canada (N.O.).
ORCID: 0000-0002-1686-2057

Yves Giguère (Y)

Reproduction, Mother and Child Health Unit, CHU De Québec-Université Laval Research Center, Université Laval, Canada. (P.G., Y.G., J.-C.F., N.C., L.G., E.B.).
Department of Molecular Biology, Medical Biochemistry and Pathology, Université Laval, Canada. (Y.G., J.-C.F.).

Jean-Claude Forest (JC)

Reproduction, Mother and Child Health Unit, CHU De Québec-Université Laval Research Center, Université Laval, Canada. (P.G., Y.G., J.-C.F., N.C., L.G., E.B.).
Department of Molecular Biology, Medical Biochemistry and Pathology, Université Laval, Canada. (Y.G., J.-C.F.).

Nils Chaillet (N)

Reproduction, Mother and Child Health Unit, CHU De Québec-Université Laval Research Center, Université Laval, Canada. (P.G., Y.G., J.-C.F., N.C., L.G., E.B.).
ORCID: 0000-0003-2466-0938

Benoit Mâsse (B)

École de Santé Publique de l'Université de Montréal, QC, Canada (B.M.).

David Wright (D)

Institute of Health Research, University of Exeter, United Kingdom (D.W.).

Louise Ghesquiere (L)

Reproduction, Mother and Child Health Unit, CHU De Québec-Université Laval Research Center, Université Laval, Canada. (P.G., Y.G., J.-C.F., N.C., L.G., E.B.).
Department of Obstetrics, Université de Lille, CHU de Lille, France (L.G.).

Emmanuel Bujold (E)

Reproduction, Mother and Child Health Unit, CHU De Québec-Université Laval Research Center, Université Laval, Canada. (P.G., Y.G., J.-C.F., N.C., L.G., E.B.).
Department of Gynecology, Obstetrics and Reproduction, Université Laval, Canada. (E.B.).
ORCID: 0000-0002-6936-4369

Classifications MeSH