Accuracy of competing‐risks model in screening for pre‐eclampsia by maternal factors and biomarkers at 11–13 weeks' gestation

O’Gorman, Neil; Wright, David; Poon, Liona C.; Rolnik, Daniel L.; Syngelaki, Argyro; Wright, A.; Akolekar, Ranjit; Cicero, S.; Janga, D.; Jani, Jacques; Molina, Francisca S.; Matallana, Catalina De Paco; Παπαντωνίου, Ν.; Persico, Nicola; Plasencia, W.; Singh, Mandeep; Nicolaides, Kypros H.

doi:10.1002/uog.17399

Cited by 201 publications

(232 citation statements)

References 18 publications

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“…With use of Bayes’ theorem to combine the a priori risk from maternal factors with uterine artery pulsatility index (UtA‐PI), mean arterial pressure (MAP), and serum placental growth factor (PlGF) at 11–13 weeks’ gestation, a study involving about 60 000 singleton pregnancies reported that such screening detected 76% and 40% of pregnancies at high‐risk of preterm and term pre‐eclampsia, respectively, at a false‐positive rate of 10% . A prospective external validation study of 8775 singleton pregnancies, including 239 (2.7%) cases that developed pre‐eclampsia, has further confirmed that the first trimester combined test achieves detection rates of 75% and 43%, respectively, for preterm and term pre‐eclampsia, at a 10% false‐positive rate …”

Section: Screeningmentioning

confidence: 99%

Good clinical practice advice: First trimester screening and prevention of pre‐eclampsia in singleton pregnancy

Renzo¹,

Gratacós²,

Курцер³

et al. 2019

Intl J Gynecology & Obste

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Section: Screeningmentioning

confidence: 99%

Good clinical practice advice: First trimester screening and prevention of pre‐eclampsia in singleton pregnancy

Renzo¹,

Gratacós²,

Курцер³

et al. 2019

Intl J Gynecology & Obste

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“…Previous PE of the pregnant woman and/or of her mother and sisters has already been identified as a major risk factor, along with black ethnicity [87], [88]. We use the term black ethnicity as statistics have shown higher rates of PE in Africa compared to Europe, and among Afro-Americans and Afro-Caribbeans compared to Caucasians.…”

Section: Targeted Approach To Combat Preeclampsiamentioning

confidence: 99%

Personalized Therapy Against Preeclampsia by Replenishing Placental Protein 13 (PP13) Targeted to Patients With Impaired PP13 Molecule or Function

Meiri¹,

Osol

Cetin

et al. 2017

Computational and Structural Biotechnology Journal

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Hypertensive disorders affect about one third of all people aged 20 and above, and are treated with anti-hypertensive drugs. Preeclampsia (PE) is one form of such disorders that only develops during pregnancy. It affects ten million pregnant women globally and additionally causes fetal loss and major newborn disabilities. The syndrome's origin is multifactorial, and anti-hypertensive drugs are ineffective in treating it. Biomarkers are helpful for predict its development. Generic drugs, such as low dose aspirin, were proven effective in preventing preterm PE. However, it does not cure the majority of cases and many studies are underway for fighting PE with extended use of additional generic drugs, or through new drug development programs.This review focuses on placental protein 13 (PP13). This protein is only expressed in the placenta. Impaired PP13 DNA structure and/or its reduced mRNA expression leads to lower blood PP13 level that predict a higher risk of developing PE. Two polymorphic PP13 variants have been identified: (1) The promoter PP13 variant with an “A/A” genotype in the -98 position (versus “A/C” or “C/C”). Having the “A/A” genotype is coupled to lower PP13 expression, mainly during placental syncytiotrophoblast differentiation and, if associated with obesity and history of previous preeclampsia, it accurately predicts higher risk for developing the disorder. (2) A thymidine deletion at position 221 causes a frame shift in the open reading frame, and the formation of an early stop codon resulting in the formation of DelT221, a truncated variant of PP13. In pregnant rodents, both short- and long- term replenishment of PP13 causes reversible hypotension and vasodilation of uterine vessels. Long-term exposure is also accompanied by the development of larger placentas and newborns. Also, only w/t PP13 is capable of inducing leukocyte apoptosis, providing maternal immune tolerance to pregnancy.Based on published data, we propose a targeted PP13 therapy to fight PE, and consider the design and conduct of animal studies to explore this hypothesis. Accordingly, a new targeted therapy can be implemented in humans combining prediction and prevention.

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“…EOPE, early-onset preeclampsia; E2, estradiol; LOPE, late-onset preeclampsia; MBL, mannose binding lectin; P4, progesterone; SP-A, surfactant protein A; SP-D, surfactant protein D. P < .05 represents a significant correlation using the Spearman method factors [eg, mean arterial pressure (MAP) and uterineartery Doppler Pulsatility Index (PI)] are being used to develop an appropriate prediction model for PE 45. Owing to severity of EOPE and associated maternal and fetal mortality and morbidity, an early detection (<14th week of gestation) has been recommended for the initiationF I G U R E 7 Correlation of P4/E2 ratio with collectins.…”

mentioning

confidence: 99%

Differential levels of surfactant protein A, surfactant protein D, and progesterone to estradiol ratio in maternal serum before and after the onset of severe early‐onset preeclampsia

Kale

Vishwekar

Balsarkar

et al. 2019

American J Rep Immunol

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Problem Preeclampsia (PE), a multifactorial disorder characterized by impaired placental development, elevated inflammatory response and dysregulated placental steroidogenesis. PE may be preventable if predicted early on. Method of study The study evaluated the potential of immunomodulatory collectins, surfactant protein A (SP‐A), surfactant protein D (SP‐D), and mannose binding lectin (MBL), to predict PE before the disease onset, in a prospective study cohort of healthy pregnant women (n = 922). In addition, a cross‐sectional study was conducted to determine the serum and placental profile of collectins in PE women after the disease onset (early‐onset PE [EOPE], n = 33; late‐onset PE [LOPE], n = 24); and controls [n = 75]. The serum profiles of estradiol (E2) and progesterone (P4) were evaluated to determine their correlation with collectins. Results In the prospective cohort, significantly decreased serum levels of SP‐A, SP‐D, P4/E2 ratio were observed in women who subsequently developed severe EOPE. Interestingly, after the disease onset, there was a significant increase in serum and placental levels of collectins in women with severe EOPE, whereas women with LOPE had significantly decreased levels of collectins. Serum P4/E2 ratio was significantly altered in severe EOPE and positively correlated with serum levels of SP‐A and SP‐D. Conclusion Collectins are differentially expressed in the serum during progression of PE. Decreased serum levels of SP‐A, SP‐D, P4/E2 ratio and increased E2 during 10‐20 weeks of gestation are novel plausible risk factors for early prediction of EOPE in Indian women.

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Accuracy of competing‐risks model in screening for pre‐eclampsia by maternal factors and biomarkers at 11–13 weeks' gestation

Abstract: Assessment of a combination of maternal factors and biomarkers at 11-13 weeks provides effective first-trimester screening for preterm PE. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Cited by 201 publications

References 18 publications

Good clinical practice advice: First trimester screening and prevention of pre‐eclampsia in singleton pregnancy

Good clinical practice advice: First trimester screening and prevention of pre‐eclampsia in singleton pregnancy

Personalized Therapy Against Preeclampsia by Replenishing Placental Protein 13 (PP13) Targeted to Patients With Impaired PP13 Molecule or Function

Differential levels of surfactant protein A, surfactant protein D, and progesterone to estradiol ratio in maternal serum before and after the onset of severe early‐onset preeclampsia

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