Screening for preeclampsia using first-trimester serum markers and uterine artery Doppler in nulliparous women
Screening for preeclampsia using first-trimester serum markers and uterine artery Doppler in nulliparous women
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DOI：
10.1016/j.ajog.2010.06.014
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发表时间：
2010-10-01
影响因子：
9.8
通讯作者：
Rey, Evelyne
中科院分区：
文献类型：
--
作者：
Audibert, Francois;Boucoiran, Isabelle;Rey, Evelyne
目的：评估孕早期母体血清生物标志物和子宫动脉多普勒筛查妊娠高血压疾病的准确性。研究设计：前瞻性入组的未产妇在第11-13周时进行子宫动脉多普勒和血清测量。记录母亲特征、子宫动脉多普勒和血清胎盘生物标志物（妊娠相关血浆蛋白 A、抑制素 A、胎盘蛋白 13、A 解整合素和金属蛋白酶 12、游离 β-hCG、胎盘生长因子）。 结果：在 893 名女性中，20 名 (2.2%) 患有妊娠高血压，40 名 (4.5%) 患有先兆子痫其中，早发型子痫前期 9 例（1.0%），重度子痫前期 16 例（1.8%）。结合临床特征、妊娠相关血浆蛋白 A、抑制素 A 和胎盘生长因子的联合筛查模型可以以 10% 的假阳性率检出 75% 的早发性先兆子痫。调整临床变量后，子宫动脉多普勒、胎盘蛋白 13、A 解整合素和金属蛋白酶 12 并未提高诊断准确性。 结论：结合临床特征和妊娠早期母体血清生物标志物（妊娠相关血浆蛋白 A、抑制素 A 和胎盘生长因子）可以准确筛查未产妇早发性先兆子痫。
OBJECTIVE: To evaluate the screening accuracy of pregnancy hypertensive disorders by maternal serum biomarkers and uterine artery Doppler in the first trimester.STUDY DESIGN: Prospectively enrolled nulliparous women had uterine artery Doppler and serum measured at 11-13 weeks. Maternal characteristics, uterine artery Doppler, and serum placental biomarkers (pregnancy-associated plasma protein-A, Inhibin-A, placental protein 13, A disintegrin and metalloprotease 12, free beta-hCG, placental growth factor) were recorded.RESULTS: Among 893 women, 20 (2.2%) had gestational hypertension developed and 40 (4.5%) had preeclampsia developed, including 9 (1.0%) early-onset preeclampsia and 16 (1.8%) severe preeclampsia. A combined screening model with clinical characteristics, pregnancy-associated plasma protein-A, Inhibin-A, and placental growth factor could detect 75% of early-onset preeclampsia at a 10% false-positive rate. After adjustment for clinical variables, uterine artery Doppler, placental protein 13, and A disintegrin and metalloprotease 12 did not improve the diagnostic accuracy.CONCLUSION: A combination of clinical characteristics and first-trimester maternal serum biomarkers (pregnancy-associated plasma protein-A, Inhibin-A, and placental growth factor) provides an accurate screening for early-onset preeclampsia in nulliparous women.