Amélie Boutin1, Suzanne Demers2, Cédric Gasse3, Yves Giguère4, Amélie Tétu1, Geneviève Laforest1, Emmanuel Bujold5,6. 1. Reproduction, Mother and Child Health Unit, CHU de Québec - Université Laval Research Center, Université Laval, Quebec City, Québec, Canada. 2. Department of Gynecology, Obstetrics and Reproduction, Faculty of Medicine, Université Laval, Quebec City, Québec, Canada. 3. Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec City, Québec, Canada. 4. Department of Molecular Biology, Medical Biochemistry and Pathology, Faculty of Medicine, Université Laval, Quebec City, Québec, Canada. 5. Reproduction, Mother and Child Health Unit, CHU de Québec - Université Laval Research Center, Université Laval, Quebec City, Québec, Canadaemmanuel.bujold@crchudequebec.ulaval.ca. 6. Department of Gynecology, Obstetrics and Reproduction, Faculty of Medicine, Université Laval, Quebec City, Québec, Canadaemmanuel.bujold@crchudequebec.ulaval.ca.
Abstract
BACKGROUND: First-trimester maternal serum markers have been associated with preeclampsia (PE). We aimed to evaluate the performance of first-trimester placental growth factor (PlGF) for the prediction of PE in nulliparous women. SUBJECTS AND METHODS: We conducted a prospective cohort study of nulliparous women with singleton pregnancy at 11-13 weeks. Maternal serum PlGF concentration was measured using B·R·A·H·M·S PlGFplus KRYPTOR automated assays and reported in multiple of the median adjusted for gestational age. We used proportional hazard models, along with receiver operating characteristic curves and areas under the curve (AUC). RESULTS: Out of 4,652 participants, we observed 232 (4.9%) cases of PE including 202 (4.3%) term and 30 (0.6%) preterm PE. PlGF was associated with the risk of term (AUC = 0.61, 95% confidence interval [CI] 0.57-0.65) and preterm PE (AUC = 0.73, 95% CI 0.64-0.83). The models were improved with the addition of maternal characteristics (AUC for term PE 0.66, 95% CI 0.62-0.71; AUC for preterm PE 0.81, 95% CI 0.72-0.91; p < 0.01). At a false-positive rate of 10%, PlGF combined with maternal characteristics could have predicted 26% of term and 55% of preterm PE. The addition of pregnancy-associated plasma protein A did not significantly improve the prediction models. CONCLUSION: First-trimester PlGF combined with maternal characteristics is useful to predict preterm PE in nulliparous women.
BACKGROUND: First-trimester maternal serum markers have been associated with preeclampsia (PE). We aimed to evaluate the performance of first-trimester placental growth factor (PlGF) for the prediction of PE in nulliparous women. SUBJECTS AND METHODS: We conducted a prospective cohort study of nulliparous women with singleton pregnancy at 11-13 weeks. Maternal serum PlGF concentration was measured using B·R·A·H·M·S PlGFplus KRYPTOR automated assays and reported in multiple of the median adjusted for gestational age. We used proportional hazard models, along with receiver operating characteristic curves and areas under the curve (AUC). RESULTS: Out of 4,652 participants, we observed 232 (4.9%) cases of PE including 202 (4.3%) term and 30 (0.6%) preterm PE. PlGF was associated with the risk of term (AUC = 0.61, 95% confidence interval [CI] 0.57-0.65) and preterm PE (AUC = 0.73, 95% CI 0.64-0.83). The models were improved with the addition of maternal characteristics (AUC for term PE 0.66, 95% CI 0.62-0.71; AUC for preterm PE 0.81, 95% CI 0.72-0.91; p < 0.01). At a false-positive rate of 10%, PlGF combined with maternal characteristics could have predicted 26% of term and 55% of preterm PE. The addition of pregnancy-associated plasma protein A did not significantly improve the prediction models. CONCLUSION: First-trimester PlGF combined with maternal characteristics is useful to predict preterm PE in nulliparous women.
Authors: Jussara Mayrink; Renato T Souza; Francisco E Feitosa; Edilberto A Rocha Filho; Débora F Leite; Janete Vettorazzi; Iracema M Calderon; Maria H Sousa; Maria L Costa; Philip N Baker; Jose G Cecatti Journal: Sci Rep Date: 2019-07-02 Impact factor: 4.379