Suzanne Demers1,2, Amélie Boutin2, Cédric Gasse2,3, Olivier Drouin1, Mario Girard2, Emmanuel Bujold1,2. 1. Department of Gynecology, Obstetrics and Reproduction, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada. 2. Reproduction, Mother and Child Health Unit, CHU de Québec-Université Laval Research Center, Quebec City, Quebec, Canada. 3. Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada.
Abstract
OBJECTIVE: This study aimed to estimate the performance of first-trimester uterine artery (UtA) pulsatility index (PI) for the prediction of preeclampsia (PE). STUDY DESIGN: We conducted a prospective cohort study of nulliparous women with singleton gestation at 11 to 13 6/7 weeks. UtA-Doppler's was performed on both UtAs and the mean UtA-PI was reported in multiple of median (MoM) adjusted for gestational age. Using receiver operating characteristic curves and their area under the curves (AUC); we calculated the performance of UtA-PI for the prediction of PE. Proportional hazard models were used to develop prediction models combining UtA-PI and maternal characteristics. RESULTS: Out of 4,676 participants with completed follow-up, 232 (4.9%) developed PE, including 202 (4.3%) term and 30 (0.6%) preterm PE. Mean UtA-PI decreased with gestational age between 11 and 13 6/7 weeks (p < 0.001). First-trimester UtA-PI was associated with preterm (AUC: 0.69; 95% CI [confidence interval]: 0.57-0.80) but not with term (AUC: 0.52; 95% CI: 0.48-0.56) PE. UtA-PI combined with maternal characteristics could predict 45% of preterm PE at a false positive rate of 10%. CONCLUSION: First-trimester UtA-PI decreases with gestational age between 11 and 13 6/7 weeks and is associated with the risk of preterm but not term PE. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: This study aimed to estimate the performance of first-trimester uterine artery (UtA) pulsatility index (PI) for the prediction of preeclampsia (PE). STUDY DESIGN: We conducted a prospective cohort study of nulliparous women with singleton gestation at 11 to 13 6/7 weeks. UtA-Doppler's was performed on both UtAs and the mean UtA-PI was reported in multiple of median (MoM) adjusted for gestational age. Using receiver operating characteristic curves and their area under the curves (AUC); we calculated the performance of UtA-PI for the prediction of PE. Proportional hazard models were used to develop prediction models combining UtA-PI and maternal characteristics. RESULTS: Out of 4,676 participants with completed follow-up, 232 (4.9%) developed PE, including 202 (4.3%) term and 30 (0.6%) preterm PE. Mean UtA-PI decreased with gestational age between 11 and 13 6/7 weeks (p < 0.001). First-trimester UtA-PI was associated with preterm (AUC: 0.69; 95% CI [confidence interval]: 0.57-0.80) but not with term (AUC: 0.52; 95% CI: 0.48-0.56) PE. UtA-PI combined with maternal characteristics could predict 45% of preterm PE at a false positive rate of 10%. CONCLUSION: First-trimester UtA-PI decreases with gestational age between 11 and 13 6/7 weeks and is associated with the risk of preterm but not term PE. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Virginia R Nuckols; Seth W Holwerda; Rachel E Luehrs; Lyndsey E DuBose; Amy K Stroud; Debra Brandt; Alexandria M Betz; Jess G Fiedorowicz; Sabrina M Scroggins; Donna A Santillan; Justin L Grobe; Curt D Sigmund; Mark K Santillan; Gary L Pierce Journal: Hypertension Date: 2020-09-21 Impact factor: 9.897