First Trimester Screening for Preeclampsia – A Systematic Review

Mosimann, Beatrice; Amylidi-Mohr, Sofia; Surbek, Daniel; Raio, Luigi

doi:10.1080/10641955.2019.1682009

Cited by 25 publications

(31 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…According to a meta-analysis on the sFlt-1/PlGF ratio, which was recently considered one of the most promising serum markers in preeclampsia prediction, the authors found an overall sensitivity of 80%, a speci city of 92%, a positive likelihood ratio of 10.5 and a negative likelihood ratio of 0.22 after pooling 15 studies involving 534 cases and 19587 controls (20). A 4-week observation window along with the cutoff value of 38 was applied in the paper by Zeisler et al, which showed that the sFlt-1/PlGF ratio could accurately exclude preeclampsia occurrence in suspicious patients, with an AUC of 0.90 in the ROC analysis compared to an AUC of 0.67 in our study with follow-up until delivery (7); however, for the remaining markers included in present study, the observation window was yet to be well-de ned; delivery remained the mainstream endpoint in most of the preeclampsia prediction studies (5,21). The average interval between blood sampling and preeclampsia diagnosis was 7 weeks with our prospective cohort, which provided important clinical evidence for future validation studies.…”

Section: Discussioncontrasting

confidence: 52%

Predictive values of multiple serum biomarkers in women with suspected preeclampsia: a prospective study

Wang

Hu²,

Liu

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Preeclampsia prediction improves maternal and fetal outcomes in pregnancy. We aimed to evaluate the preeclampsia prediction values of a series of serum biomarkers. Methods: Singleton pregnant women with preeclampsia-related clinical and/or laboratory presentations were recruited and had blood drawn at their first visits. The prospective cohort was further divided into preeclampsia-positive and preeclampsia-negative groups based on the follow-up results. The following markers were tested using the collected serum samples: soluble fms-like tyrosine kinase-1 ( sFlt-1); placental growth factor (PlGF); thrombomodulin (TM); tissue plasminogen activator inhibitor complex (tPAI-C); compliment factors C1q, B, and H; glycosylated fibronectin (GlyFn); pregnancy-associated plasma protein-A2 ( PAPP-A2); blood urea nitrogen (BUN); creatinine (Cre); uric acid (UA); and cystatin C (Cysc). Results: A total of 196 women with suspected preeclampsia were recruited with follow-up medical records. Twenty-five percent (n=49) of the recruited subjects developed preeclampsia before delivery, and 75% remained preeclampsia-negative (n=147). The serum levels of sFlt-1, BUN, Cre, UA, Cysc and PAPP-A2 were significantly elevated, and the PlGF level was significantly decreased in the preeclampsia-positive patients. In the receiver operating characteristics (ROC) analyses, the area under the curves were listed in the order of decreasing values: 0.73 (UA), 0.67 (sFlt-1/PlGF), 0.66 (Cysc), 0.65 (GlyFn/PlGF), 0.64 (PAPP-A2/PlGF), 0.63 (BUN), 0.63 (Cre), and 0.60 (PAPP-A2). With the cut-off values obtained from the ROC analyses, the positive predictive values of these serum markers were between 33.1% and 58.5%, and the negative predictive values were between 80.9% and 89.5%. Conclusions: Further studies are warranted to confirm the clinical utilities of the serum markers in preeclampsia prediction

show abstract

Section: Discussioncontrasting

confidence: 52%

Predictive values of multiple serum biomarkers in women with suspected preeclampsia: a prospective study

Wang

Hu²,

Liu

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…A 4‐week observation window along with the cutoff value of 38 was applied in the article by Zeisler et al, 7 which showed that the sFlt‐1/PlGF ratio could accurately exclude preeclampsia occurrence in suspicious patients, with an AUC of 0.90 in the ROC analysis compared to an AUC of 0.67 in our study with follow‐up until delivery; however, for the remaining markers included in present study, the observation window was yet to be well‐defined; delivery remained the mainstream endpoint in most of the preeclampsia prediction studies 5,20 . The average interval between blood sampling and preeclampsia diagnosis was 7 weeks with our prospective cohort, which provided important clinical evidence for future validation studies.…”

Section: Discussionmentioning

confidence: 93%

Predictive values of various serum biomarkers in women with suspected preeclampsia: A prospective study

Wang

Hu²,

Liu

et al. 2021

Clinical Laboratory Analysis

View full text Add to dashboard Cite

Background Preeclampsia (PE) prediction has been shown to improve the maternal and fetal outcomes in pregnancy. We aimed to evaluate the PE prediction values of a series of serum biomarkers. Methods The singleton pregnant women (20–36 gestational weeks) with PE‐related clinical and/or laboratory presentations were recruited and had the blood drawn at their first visits. The following markers were tested with the collected serum samples: soluble fms‐like tyrosine kinase 1 (sFlt‐1), placental growth factor (PlGF), thrombomodulin (TM), tissue plasminogen activator inhibitor complex (tPAI‐C), complement factors C1q, B, H, glycosylated fibronectin (GlyFn), pregnancy‐associated plasma protein‐A2 (PAPP‐A2), blood urea nitrogen (BUN), creatinine (Cre), uric acid (UA), and cystatin C (Cysc). Results Of the 196 recruited subjects, 25% (n = 49) developed preeclampsia before delivery, and 75% remained preeclampsia negative (n = 147). The serum levels of sFlt‐1, BUN, Cre, UA, Cysc, and PAPP‐A2 were significantly elevated, and the PlGF level was significantly decreased in the preeclampsia‐positive patients. In the receiver operating characteristics (ROC) analyses, the area under the curves were listed in the order of decreasing values: 0.73 (UA), 0.67 (sFlt‐1/PlGF), 0.66 (Cysc), 0.65 (GlyFn/PlGF), 0.64 (PAPP‐A2/PlGF), 0.63 (BUN), 0.63 (Cre), and 0.60 (PAPP‐A2). The positive predictive values of these serum markers were between 33.1% and 58.5%, and the negative predictive values were between 80.9% and 89.5%. Conclusions The serum markers investigated in current study showed better performance in ruling out than ruling in PE. Absence of pre‐defined latency period between blood draw and the onset of PE limits the clinical utility of these markers.

show abstract

“…Placenta-related pregnancy complications, including preterm birth, hypertensive disorders, and fetal growth restriction, represent the most relevant contributor to maternal and neonatal morbidity and mortality and are known to be strongly associated with maternal nutritional behaviors [ 2 , 39 , 40 ]. First trimester maternal serum biomarkers and uterine artery doppler indices have shown promising capacities in the prediction of early and severe preeclampsia, as well as interesting associations with further obstetric complications, including gestational diabetes and intrauterine growth restriction, thus explaining the relevance of investigating environmental factors and exposures able to impact on early markers of embryonic and placental dysfunction [ 21 , 41 , 42 , 43 , 44 , 45 ]. This knowledge could provide more and more precise prediction models of clinical diseases and pregnancy outcome, improve placental development, and develop preventive strategies to finally improve the health outcome of future generations [ 21 , 42 , 43 , 44 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

Associations between First Trimester Maternal Nutritional Score, Early Markers of Placental Function, and Pregnancy Outcome

et al. 2020

View full text Add to dashboard Cite

This study investigated the associations between maternal adherence to a healthy diet, first trimester placental markers, and pregnancy outcome. Singleton spontaneous pregnancies were enrolled at 11+0–13+6 gestational weeks in a prospective cohort study. A nutritional score (0–10) measuring the adherence to a healthy diet was calculated. A transabdominal ultrasound scan for placental marker assessment was performed (uterine artery (UtA) doppler, placental volume). Biochemical placental markers were recorded (Pregnancy Associated Plasma Protein A (PAPP-A), free β- Human Chorionic Gonadotropin (HCG)). Birth outcomes were obtained from medical records. Associations between the maternal nutritional score, first trimester placental markers, and pregnancy outcome were investigated by using multi-adjusted general linear models. In total, 112 pregnancies were enrolled with a median nutritional score of 7 (range 3–10). Median gestational age at birth was 277 days (range 203–296). The nutritional score was positively associated with PAPP-A concentrations, whereas a negative association was detected with the UtA mean pulsatility index and placental volume. A positive association was detected between nutritional score and gestational age at birth. This study demonstrates that a first trimester nutritional score as a measure of adherence to a healthy diet is significantly associated with early biochemical and ultrasound markers of placental development, with further association with gestational age at birth.

show abstract

First Trimester Screening for Preeclampsia – A Systematic Review

Cited by 25 publications

References 44 publications

Predictive values of multiple serum biomarkers in women with suspected preeclampsia: a prospective study

Predictive values of multiple serum biomarkers in women with suspected preeclampsia: a prospective study

Predictive values of various serum biomarkers in women with suspected preeclampsia: A prospective study

Associations between First Trimester Maternal Nutritional Score, Early Markers of Placental Function, and Pregnancy Outcome

Contact Info

Product

Resources

About