First-trimester placental protein 13, PAPP-A, uterine artery Doppler and maternal characteristics in the prediction of pre-eclampsia

Abstract Objective To test the hypothesis that a combination of PP13, PAPP-A and first-trimester uterine artery Doppler would improve the prediction of pre-eclampsia. Methods This is a prospective cohort study of pregnant women followed from the first-trimester to delivery. PP13 and PAPP-A were dete...

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Bibliographic Details
Published in:	Placenta (Eastbourne) Vol. 32; no. 8; pp. 598 - 602
Main Authors:	Odibo, A.O, Zhong, Y, Goetzinger, K.R, Odibo, L, Bick, J.L, Bower, C.R, Nelson, D.M
Format:	Journal Article
Language:	English
Published:	Kidlington Elsevier Ltd 01-08-2011 Elsevier
Subjects:	Adult Biological and medical sciences Biomarkers - blood Cohort Studies Embryology: invertebrates and vertebrates. Teratology Female Fundamental and applied biological sciences. Psychology Galectins - analysis Humans Internal Medicine Obstetrics and Gynecology PAPP-A PP13 pre-eclampsia Pre-Eclampsia - diagnosis Prediction Pregnancy Pregnancy Proteins - analysis Pregnancy Trimester, First Pregnancy-Associated Plasma Protein-A - analysis Prospective Studies Sensitivity and Specificity Ultrasonography, Doppler Uterine artery Uterine Artery - diagnostic imaging Uterine Artery - physiology PAPP-A pre-eclampsia Uterine artery PP13 Prediction Sonography Doppler ultrasound study Placental protein Pregnancy disorders Characteristic First trimester Pregnancy associated plasma protein A Protein A Pregnancy toxemia Pregnancy Vertebrata Mammalia Mother Blood vessel Preeclampsia Circulatory system
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Summary:	Abstract Objective To test the hypothesis that a combination of PP13, PAPP-A and first-trimester uterine artery Doppler would improve the prediction of pre-eclampsia. Methods This is a prospective cohort study of pregnant women followed from the first-trimester to delivery. PP13 and PAPP-A were determined by immunoassay of maternal serum at 11–14 weeks’, when uterine artery Doppler measurements were assessed. Cases identified with any form of pre-eclampsia were compared with a control group without pre-eclampsia. The sensitivity of each marker or their combinations in predicting pre-eclampsia for different fixed false positive rates was calculated from the ROC curves. Results Forty two women were diagnosed with pre-eclampsia and 410 women with pregnancies not complicated by pre-eclampsia were used as controls. For a fixed false positive rate (FPR) of 20%, PP13, PAPP-A and mean uterine artery pulsatility index identified 49%, 58% and 62% respectively, of women who developed any form of pre-eclampsia. PP13 was best in predicting early onset pre-eclampsia with a sensitivity of 79% at a 20% FPR. Combinations of the three first-trimester assessments did not improve the prediction of pre-eclampsia in later pregnancy. Conclusion First-trimester PP13, PAPP-A and uterine artery PI are reasonable, individual predictors of women at risk to develop pre-eclampsia. Combinations of these assessments do not further improve the prediction of pre-eclampsia.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0143-4004 1532-3102
DOI:	10.1016/j.placenta.2011.05.006