Cut-off values for Gaussian first-trimester screening for early-onset preeclampsia with maternal history, biochemical markers and uterine artery Doppler

Mendoza, Manel; Tur, Helena; Garcia‐Manau, Pablo; Hurtado, Ivan; Serrano, Berta; López-Martínez, Rosa; Castellote, Laura; Martinez, L. Hurtado; Bonacina, Erika; Carreras, E.

doi:10.1016/j.jogoh.2020.101827

Cited by 12 publications

(19 citation statements)

References 25 publications

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“…10 In our cohort, at a 10% FPR, 62.5% of early SGA and 27.3% of preterm SGA could be identified. For this reason, our results have important clinical implications as first-trimester screening for early-onset PE by using the Gaussian algorithm at a 10% FPR (cut-off ≤1/118) 25 and use of ASA in the high-risk group would not only reduce the incidence of pre-eclampsia, but also the incidence of early SGA by 45.6% and of preterm SGA by 10.9%. In addition to that, the specific algorithms for the prediction of SGA have shown similar performance to that of the Gaussian algorithm to predict SGA.…”

Section: Discussionmentioning

confidence: 83%

Diagnostic accuracy of the Gaussian first‐trimester combined screening for pre‐eclampsia to predict small‐for‐gestational‐age neonates

Mendoza

Serrano

Bonacina

et al. 2021

Intl J Gynecology & Obste

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Objective: Pre-eclampsia and delivery of small-for-gestational-age (SGA) neonates can be predicted from the first trimester. A Gaussian model for prediction of PE has recently been described, although its capacity to predict SGA is still unknown.Methods: This was a secondary analysis of a prospective cohort study conducted at Vall d'Hebron University Hospital (Barcelona) in 2483 single pregnancies from October 2015 to September 2017. Mean arterial blood pressure and mean uterine artery pulsatility index were recorded at the first-trimester scan. Serum concentrations of placental growth factor and pregnancy-associated plasma protein-A were assessed between 8 +0 and 13 +6 weeks. The predictive capacities of early (<32 weeks) and preterm (<37 weeks) SGA were tested. Results:For SGA without pre-eclampsia, detection rates of 25.0% (95% confidence interval [CI] 0-75.0) for early SGA and 14.3% (95% CI 3.6-28.6) for preterm SGA were achieved. For SGA with pre-eclampsia, the algorithm showed detection rates of 100.0% (95% CI 25.0-100.0) for early 3) for preterm SGA. Conclusion:This algorithm identifies 62.5% of early SGA and 27.3% of preterm SGA.Combined screening for predicting both pre-eclampsia and SGA by using the Gaussian algorithm is feasible and would simplify clinical practice.

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Section: Discussionmentioning

confidence: 83%

Diagnostic accuracy of the Gaussian first‐trimester combined screening for pre‐eclampsia to predict small‐for‐gestational‐age neonates

Mendoza

Serrano

Bonacina

et al. 2021

Intl J Gynecology & Obste

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“…1/170. This cut-off value provides a 90.9% detection rate for early-onset PE at a 12.7% false-positive rate 12 .…”

Section: Methodsmentioning

confidence: 97%

The role of shared risk factors for COVID-19 and preeclampsia: An observational study

Serrano¹,

Mendoza²,

Garcia‐Aguilar³

et al. 2022

Preprint

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Objective: To examine baseline risk factors measured in the first-trimester screening for preeclampsia (PE) in pregnant women with COVID-19 versus the general population. To compare risk factors among patients with mild and severe COVID-19. Design: Observational retrospective study. Setting: Six maternities in Catalonia. Population: Study patients were 231 pregnant women undergoing first-trimester screening for PE and positive for SARS-CoV-2. Reference cohort were 13,033 pregnant women with first-trimester screening for PE from 6 maternities. Methods: Recording of maternal history, mean arterial blood pressure (MAP), mean uterine artery pulsatility index (UtAPI), placental growth factor (PlGF) and pregnancy-associated plasma protein-A at first trimester. Confirmation of SARS-CoV-2 infection. Based on the need for hospitalization, patients were classified into mild and severe COVID-19. Main outcome measures: Comparison of proportion of cases at a high risk for PE and of risk factors for PE among groups. Results: High risk for PE was significantly higher amongst COVID-19 patients compared to the general population, showing higher rates of obesity, chronic hypertension, higher UtAPI, and lower rates of smokers. PlGF did not differ significantly. In women with severe COVID-19, compared with mild COVID-19, BMI and MAP were significantly higher, whereas PlGF and UtAPI did not differ significantly. Conclusions: In patients with COVID-19 there was a higher proportion of women at a high risk for PE than in the general population, mainly due to maternal risk factors, rather than placental signs of a deficient trophoblastic invasion. Likewise, according to COVID-19 severity, differences were due to maternal risk factors only.

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“…The prenatal screening software SsdwLab6 (SBP Soft 2007 S.L; Girona, Spain), which was being used for chromosomopathy screening in all participating sites, was also used for PE risk assessment. Women with a risk of at least 1/137 were considered to be at a high risk of PE and were offered daily ASA at a dose of 150 mg (Tromalyt; Mylan Pharmaceuticals, S.L., Madrid, Spain) taken at night from the first‐trimester scan until 36 weeks 10 . Treatment compliance was checked at every appointment with the patient and was confirmed by pharmacy dispensing records (in Catalonia all drugs are prescribed electronically).…”

Section: Methodsmentioning

confidence: 99%

Implementation of routine first‐trimester combined screening for preeclampsia based on the Gaussian algorithm: A clinical effectiveness study

Mendoza

Bonacina

Serrano

et al. 2022

Intl J Gynecology & Obste

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Objective: To evaluate the clinical effectiveness of the routine first-trimester screening for preeclampsia (PE) after being implemented in six Catalan maternities. Methods: Participants in the reference group were recruited prospectively between October 2015 and September 2017. Participants in the study group were recruited retrospectively between November 2018 and May 2019, after implementing the screening program. PE risk was assessed between 11 + 0 and 13 + 6 weeks of gestation using the Gaussian algorithm combining maternal characteristics, mean arterial blood pressure, uterine artery pulsatility index, and maternal serum pregnancy-associated plasma protein-A. Women with a risk ≥1/137 were prescribed daily salicylic acid (150 mg) until 36 weeks of gestation.Results: Preterm PE occurred in 30 of 2641 participants (1.14%) in the reference group, as compared with 18 of 2848 participants (0.63%) in the study group (OR: 0.55; 95% CI, 0.31-0.99; P = 0.045). In the reference group, 37 participants (1.40%) were admitted to ICU, as compared with 23 participants (0.81%) in the study group

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Cut-off values for Gaussian first-trimester screening for early-onset preeclampsia with maternal history, biochemical markers and uterine artery Doppler

Cited by 12 publications

References 25 publications

Diagnostic accuracy of the Gaussian first‐trimester combined screening for pre‐eclampsia to predict small‐for‐gestational‐age neonates

Diagnostic accuracy of the Gaussian first‐trimester combined screening for pre‐eclampsia to predict small‐for‐gestational‐age neonates

The role of shared risk factors for COVID-19 and preeclampsia: An observational study

Implementation of routine first‐trimester combined screening for preeclampsia based on the Gaussian algorithm: A clinical effectiveness study

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