Prediction of early, intermediate and late pre-eclampsia from maternal factors, biophysical and biochemical markers at 11-13 weeks
Prediction of early, intermediate and late pre-eclampsia from maternal factors, biophysical and biochemical markers at 11-13 weeks
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DOI：
10.1002/pd.2660
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发表时间：
2011-01-01
影响因子：
3
通讯作者：
Nicolaides, Kypros H.
中科院分区：
文献类型：
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作者：
Akolekar, Ranjit;Syngelaki, Argyro;Nicolaides, Kypros H.
目的建立基于母体因素和11-13周生物物理、生化指标预测子痫前期（preeclampsia，PE）的模型。方法对11- 13周单胎妊娠进行筛查，其中752例（2.2%）发生PE，32850例未发生PE。模型被开发用于预测早期PE，需要在34周前分娩，中期PE在34-37周分娩，晚期PE在37周后分娩。用于模型的数据首先是母体特征和病史、子宫动脉搏动指数、平均动脉压和从筛选研究获得的血清妊娠相关血浆蛋白-A，其次是母体血清或血浆中胎盘生长因子、胎盘蛋白-13、白蛋白-A、激活素-A、可溶性内皮糖蛋白、结果在仅以5%的固定假阳性率进行母体因素PE筛查时，早期PE的估计检出率为33.0%，中期PE为27.8%，晚期PE为24.5%。母体因素、生物物理指标和生化指标联合筛查的检出率分别为91.0%、79.4%和60.9%。版权所有（C）2011约翰威利父子有限公司
Objective To develop models for prediction of pre-eclampsia (PE) based on maternal factors and biophysical and biochemical markers at 11-13 weeks' gestation.Methods Screening study of singleton pregnancies at 11-13 weeks including 752 (2.2%) that subsequently developed PE and 32 850 that were unaffected by PE. Models were developed for the prediction of early PE, requiring delivery before 34 weeks, intermediate PE with delivery at 34-37 weeks and late PE delivering after 37 weeks. The data used for the models were firstly, maternal characteristics and history, uterine artery pulsatility index, mean arterial pressure and serum pregnancy-associated plasma protein-A obtained from the screening study and secondly, maternal serum or plasma concentration of placental growth factor, placental protein-13, inhibin-A, activin-A, soluble endoglin, pentraxin-3 and P-selectin obtained from case-control studies.Results In screening for PE by maternal factors only at a fixed false positive rate of 5%, the estimated detection rates were 33.0% for early PE, 27.8% for intermediate PE and 24.5% for late PE. The respective detection rates in screening by a combination of maternal factors, biophysical and biochemical markers were 91.0, 79.4 and 60.9%.Conclusions Effective prediction of PE can be achieved at 11-13 weeks' gestation. Copyright (C) 2011 John Wiley & Sons, Ltd.