Skip to main content

Advertisement

SpringerLink
Log in

New Predictive Model at 11+0 to 13+6 Gestational Weeks for Early-Onset Preeclampsia With Fetal Growth Restriction

  • Original Article
  • Published:
Reproductive Sciences Aims and scope Submit manuscript

Abstract

The aim of the present study was to determine a predictive model for early-onset preeclampsia with fetal growth restriction (FGR) to be used at 11+0 to 13+6 gestational weeks, by combining the maternal serum level of pregnancy-associated plasma protein-A (PAPP-A), placental growth factor (PLGF), placental protein 13 (PP13), soluble endoglin (sEng), mean arterial pressure (MAP), and uterine artery Doppler. This was a retrospective cohort study of 4453 pregnant women. Uterine artery Doppler examination was conducted in the first trimester. Maternal serum PAPP-A, PLGF, PP13, and sEng were measured. Mean arterial pressure was obtained. Women were classified as with/without early-onset preeclampsia, and women with preeclampsia were classified as with/without FGR. Receiver operating characteristic analysis was performed to determine the value of the model. There were 30 and 32 pregnant women with early-onset preeclampsia with and without FGR. The diagnosis rate of early-onset preeclampsia with FGR was 67.4% using the predictive model when the false positive rate was set at 5% and 73.2% when the false positive rate was 10%. The predictive model (MAP, uterine artery Doppler measurements, and serum biomarkers) had some predictive value for the early diagnosis (11+0 to 13+6 gestational weeks) of early-onset preeclampsia with FGR.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Leeman L, Fontaine P. Hypertensive disorders of pregnancy. Am Fam Physician. 2008;78(1):93–100.

    PubMed  Google Scholar 

  2. Lindheimer MD, Taler SJ, Cunningham FG, American Society of Hypertension. ASH position paper: hypertension in pregnancy. J Clin Hypertens (Greenwich). 2009;11(4):214–225.

    Article  Google Scholar 

  3. Ananth CV, Keyes KM, Wapner RJ. Pre-eclampsia rates in the United States, 1980-2010: age-period-cohort analysis. BMJ. 2013;347:f6564.

    Article  Google Scholar 

  4. Waterstone M, Bewley S, Wolfe C. Incidence and predictors of severe obstetric morbidity: case-control study. BMJ. 2001;322(7294):1089–1093; discussion 1093-1084.

    Article  CAS  Google Scholar 

  5. Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet. 2010;376(9741):631–644.

    Article  Google Scholar 

  6. Magee LA, Pels A, Helewa M, et al.; Canadian Hypertensive Disorders of Pregnancy Working Group. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executive summary [In English, French]. J Obstet Gynaecol Can. 2014;36(5):416–441.

    Article  Google Scholar 

  7. Polsani S, Phipps E, Jim B. Emerging new biomarkers of preeclampsia. Adv Chronic Kidney Dis. 2013;20(3):271–279.

    Article  Google Scholar 

  8. Carty DM, Delles C, Dominiczak AF. Novel biomarkers for predicting preeclampsia. Trends Cardiovasc Med. 2008;18(5):186–194.

    Article  CAS  Google Scholar 

  9. Lovgren TR, Dugoff L, Galan HL. Uterine artery Doppler and prediction of preeclampsia. Clin Obstet Gynecol. 2010;53(4):888–898.

    Article  Google Scholar 

  10. Myatt L, Clifton RG, Roberts JM, et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network (MFMU). The utility of uterine artery Doppler velocimetry in prediction of preeclampsia in a low-risk population. Obstet Gynecol. 2012;120(4):815–822.

    Article  Google Scholar 

  11. Cnossen JS, Morris RK, ter Riet G, et al. Use of uterine artery Doppler ultrasonography to predict pre-eclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis. CMAJ. 2008;178(6):701–711.

    Article  Google Scholar 

  12. American College of Obstetricians and Gynecologists. Diagnosis and Management of Preeclampsia and Eclampsia. ACOG Practice Bulletin no. 33. Washington, DC: The College; 2002.

    Google Scholar 

  13. Spencer K, Liao AW, Ong CY, Geerts L, Nicolaides KH. First trimester maternal serum placenta growth factor (PIGF) concentrations in pregnancies with fetal trisomy 21 or trisomy 18. Prenat Diagn. 2001;21(9):718–722.

    Article  CAS  Google Scholar 

  14. Plasencia W, Maiz N, Bonino S, Kaihura C, Nicolaides KH. Uterine artery Doppler at 11 + 0 to 13 + 6 weeks in the prediction of pre-eclampsia. Ultrasound Obstet Gynecol. 2007;30(5):742–749.

    Article  CAS  Google Scholar 

  15. Noris M, Perico N, Remuzzi G. Mechanisms of disease: pre-eclampsia. Nat Clin Pract Nephrol. 2005;1(2):98–114; quiz 120.

    Article  CAS  Google Scholar 

  16. Palei AC, Spradley FT, Warrington JP, George EM, Granger JP. Pathophysiology of hypertension in pre-eclampsia: a lesson in integrative physiology. Acta Physiol (Oxf). 2013;208(3):224–233.

    Article  CAS  Google Scholar 

  17. Wortelboer EJ, Koster MP, Cuckle HS, Stoutenbeek PH, Schielen PC, Visser GH. First-trimester placental protein 13 and placental growth factor: markers for identification of women destined to develop early-onset pre-eclampsia. BJOG. 2010;117(11):1384–1389.

    Article  CAS  Google Scholar 

  18. Pandya P, Wright D, Syngelaki A, Akolekar R, Nicolaides KH. Maternal serum placental growth factor in prospective screening for aneuploidies at 8-13 weeks’ gestation. Fetal Diagn Ther. 2012;31(2):87–93.

    Article  Google Scholar 

  19. Cowans NJ, Spencer K, Meiri H. First-trimester maternal placental protein 13 levels in pregnancies resulting in adverse outcomes. Prenat Diagn. 2008;28(2):121–125.

    Article  CAS  Google Scholar 

  20. Chafetz I, Kuhnreich I, Sammar M, et al. First-trimester placental protein 13 screening for preeclampsia and intrauterine growth restriction. Am J Obstet Gynecol. 2007;197(1):35.e31–e37.

    Article  Google Scholar 

  21. Verlohren S, Herraiz I, Lapaire O, et al. The sFlt-1/PlGF ratio in different types of hypertensive pregnancy disorders and its prognostic potential in preeclamptic patients. Am J Obstet Gynecol. 2012;206(1):58.e51–e58.

    Article  Google Scholar 

  22. Poon LC, Zaragoza E, Akolekar R, Anagnostopoulos E, Nicolaides KH. Maternal serum placental growth factor (PlGF) in small for gestational age pregnancy at 11(+0) to 13(+6) weeks of gestation. Prenat Diagn. 2008;28(12):1110–1115.

    Article  Google Scholar 

  23. Gilbert JS, Ryan MJ, LaMarca BB, Sedeek M, Murphy SR, Granger JP. Pathophysiology of hypertension during preeclampsia: linking placental ischemia with endothelial dysfunction. Am J Physiol Heart Circ Physiol. 2008;294(2):H541–H550.

    Article  CAS  Google Scholar 

  24. Ghosh SK, Raheja S, Tuli A, Raghunandan C, Agarwal S. Can maternal serum placental growth factor estimation in early second trimester predict the occurrence of early onset preeclampsia and/or early onset intrauterine growth restriction? a prospective cohort study. J Obstet Gynaecol Res. 2013;39(5):881–890.

    Article  Google Scholar 

  25. Ghosh SK, Raheja S, Tuli A, Raghunandan C, Agarwal S. Is serum placental growth factor more effective as a biomarker in predicting early onset preeclampsia in early second trimester than in first trimester of pregnancy? Arch Gynecol Obstet 2013;287(5):865–873.

    Article  CAS  Google Scholar 

  26. Rana S, Karumanchi SA, Levine RJ, et al. Sequential changes in antiangiogenic factors in early pregnancy and risk of developing preeclampsia. Hypertension. 2007;50(1):137–142.

    Article  CAS  Google Scholar 

  27. Guzin K, Tomruk S, Tuncay YA, et al. The relation of increased uterine artery blood flow resistance and impaired trophoblast invasion in pre-eclamptic pregnancies. Arch Gynecol Obstet 2005;272(4):283–288.

    Article  Google Scholar 

  28. Melchiorre K, Wormald B, Leslie K, Bhide A, Thilaganathan B. First-trimester uterine artery Doppler indices in term and preterm pre-eclampsia. Ultrasound Obstet Gynecol 2008;32(2):133–137.

    Article  CAS  Google Scholar 

  29. Odibo AO, Zhong Y, Goetzinger KR, et al. First-trimester placental protein 13, PAPP-A, uterine artery Doppler and maternal characteristics in the prediction of pre-eclampsia. Placenta. 2011;32(8):598–602.

    Article  CAS  Google Scholar 

  30. Kuc S, Wortelboer EJ, van Rijn BB, Franx A, Visser GH, Schielen PC. Evaluation of 7 serum biomarkers and uterine artery Doppler ultrasound for first-trimester prediction of preeclampsia: a systematic review. Obstet Gynecol Surv. 2011;66(4):225–239.

    Article  Google Scholar 

  31. Poon LC, Karagiannis G, Staboulidou I, Shafiei A, Nicolaides KH. Reference range of birth weight with gestation and first-trimester prediction of small-for-gestation neonates. Prenat Diagn. 2011;31(1):58–65.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Obstetrics Department, Tianjin Center Hospital of Obstetrics and Gynecology, Tianjin, 300052, China

    Ying Chang MD, Xu Chen BS, Hong-Yan Cui MD, Xing Li MS & Ya-Ling Xu MS

Authors
  1. Ying Chang MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xu Chen BS
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hong-Yan Cui MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xing Li MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ya-Ling Xu MS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Xu Chen BS.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chang, Y., Chen, X., Cui, HY. et al. New Predictive Model at 11+0 to 13+6 Gestational Weeks for Early-Onset Preeclampsia With Fetal Growth Restriction. Reprod. Sci. 24, 783–789 (2017). https://doi.org/10.1177/1933719116669053

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1177/1933719116669053

Keywords

Search

Navigation