First trimester screening of maternal placental protein 13 for predicting preeclampsia and small for gestational age: In-house study and systematic review

Schneuer, Francisco J.; Nassar, Natasha; Khambalia, Amina; Tasevski, Vitomir; Ashton, Anthony W.; Morris, Jonathan M.; Roberts, Christine L.

doi:10.1016/j.placenta.2012.05.012

Cited by 32 publications

(25 citation statements)

References 33 publications

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“…Previous studies on the predictive properties of PP-13 for pre-eclampsia and SGA yielded conflicting results. While some studies found significantly lower first-trimester levels of PP-13 in pregnancy complicated by pre-eclampsia [3,6,10,[12][13][14]29] or SGA [6,15,29] suggesting a potential incorporation of this biomarker in the risk assessment for pre-eclampsia, especially for the early-onset form [3,10], other cohorts and case-control studies failed to find such associations [16][17][18][19]. Moreover, even when a significant association is found, the predictive accuracy varies, with some studies showing promising results [3,6,[10][11][12] and others showing less remarkable predictive properties [13-15, 24, 29].…”

Section: Discussionmentioning

confidence: 98%

“…Moreover, even when a significant association is found, the predictive accuracy varies, with some studies showing promising results [3,6,[10][11][12] and others showing less remarkable predictive properties [13-15, 24, 29]. In their systematic review and meta-analysis of 8 studies, Schneuer et al reported sensitivity rates of 24% and 45% for pre-eclampsia and early-onset pre-eclampsia, respectively, at 5% false positive rate [29]. In a more recent metaanalysis of 19 studies, the detection rate ranged from 47% for all cases of pre-eclampsia to 83% for early cases alone, at a 10% false positive rate [30].…”

Section: Discussionmentioning

confidence: 99%

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Relationship between first-trimester serum placental protein-13 and maternal characteristics, placental Doppler studies and pregnancy outcome

Seravalli

Grimpel

Meiri³

et al. 2016

Journal of Perinatal Medicine

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Relationship between first-trimester serum placental protein-13 and maternal characteristics, placental Doppler studies and pregnancy outcome

Seravalli

Grimpel

Meiri³

et al. 2016

Journal of Perinatal Medicine

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“…The angiogenic markers are most promising, particularly PlGF and sFlt‐1. Of the placental proteins, PP‐13 and PAPP‐A were associated most consistently with pre‐eclampsia. Large prospective studies using biomarkers are expensive, and most existing data are on markers obtained routinely during fetal anomaly screening.…”

Section: Discussionmentioning

confidence: 99%

Prediction of pre‐eclampsia: review of reviews

Townsend

Khalil

Premakumar

et al. 2019

Ultrasound in Obstet & Gyne

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Objective Primary studies and systematic reviews provide estimates of varying accuracy for different factors in the prediction of pre‐eclampsia. The aim of this study was to review published systematic reviews to collate evidence on the ability of available tests to predict pre‐eclampsia, to identify high‐value avenues for future research and to minimize future research waste in this field. Methods MEDLINE, EMBASE and The Cochrane Library including DARE (Database of Abstracts of Reviews of Effects) databases, from database inception to March 2017, and bibliographies of relevant articles were searched, without language restrictions, for systematic reviews and meta‐analyses on the prediction of pre‐eclampsia. The quality of the included reviews was assessed using the AMSTAR tool and a modified version of the QUIPS tool. We evaluated the comprehensiveness of search, sample size, tests and outcomes evaluated, data synthesis methods, predictive ability estimates, risk of bias related to the population studied, measurement of predictors and outcomes, study attrition and adjustment for confounding. Results From 2444 citations identified, 126 reviews were included, reporting on over 90 predictors and 52 prediction models for pre‐eclampsia. Around a third (n = 37 (29.4%)) of all reviews investigated solely biochemical markers for predicting pre‐eclampsia, 31 (24.6%) investigated genetic associations with pre‐eclampsia, 46 (36.5%) reported on clinical characteristics, four (3.2%) evaluated only ultrasound markers and six (4.8%) studied a combination of tests; two (1.6%) additional reviews evaluated primary studies investigating any screening test for pre‐eclampsia. Reviews included between two and 265 primary studies, including up to 25 356 688 women in the largest review. Only approximately half (n = 67 (53.2%)) of the reviews assessed the quality of the included studies. There was a high risk of bias in many of the included reviews, particularly in relation to population representativeness and study attrition. Over 80% (n = 106 (84.1%)) summarized the findings using meta‐analysis. Thirty‐two (25.4%) studies lacked a formal statement on funding. The predictors with the best test performance were body mass index (BMI) > 35 kg/m2, with a specificity of 92% (95% CI, 89–95%) and a sensitivity of 21% (95% CI, 12–31%); BMI > 25 kg/m2, with a specificity of 73% (95% CI, 64–83%) and a sensitivity of 47% (95% CI, 33–61%); first‐trimester uterine artery pulsatility index or resistance index > 90th centile (specificity 93% (95% CI, 90–96%) and sensitivity 26% (95% CI, 23–31%)); placental growth factor (specificity 89% (95% CI, 89–89%) and sensitivity 65% (95% CI, 63–67%)); and placental protein 13 (specificity 88% (95% CI, 87–89%) and sensitivity 37% (95% CI, 33–41%)). No single marker had a test performance suitable for routine clinical use. Models combining markers showed promise, but none had undergone external validation. Conclusions This review of reviews calls into question the need for further aggregate meta‐analy...

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“…This is in line with the conclusions of a recent systematic review, which found significant variability in the performance of this analyte and concluded that, despite early promising data, it does not appear that PP13 is of clinical utility. 49 …”

Section: Discussionmentioning

confidence: 99%

First-trimester placental ultrasound and maternal serum markers as predictors of small-for-gestational-age infants

Schwartz

Sammel

Leite

et al. 2014

American Journal of Obstetrics and Gynecology

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Objective To combine early, direct assessment of the placenta with indirect markers of placental development to identify pregnancies at greatest risk of delivering small-for-gestational age infants (SGA10). Methods We prospectively collected 3D-ultrasound volume sets, uterine artery pulsatility index (UtAPI) and maternal serum of singleton pregnancies at 11–14 weeks. Placental volume (PV), quotient (PQ=PV/gestational age), mean placental and chorionic diameters (MPD and MCD, respectively), and the placental morphology index (PMI=MPD/PQ and adjusts the lateral placental dimensions for quotient) were measured offline. Maternal serum was assayed for placental growth factor (PlGF) and placental protein-13 (PP13). These variables were evaluated as predictors of SGA10. Results Of the 578 pregnancies included in the study, 56 (9.7%) delivered SGA10. SGA10 pregnancies had a significantly smaller PV, PQ, MPD and MCD and higher PMI compared to normal pregnancies (P<0.001 for each). Each placental measure remained significantly associated with SGA10 after adjusting for confounders and significantly improved the performance of the model using clinical variables alone (P<0.04 for each) with adjusted AUCs ranging from 0.71 to 0.74. UtAPI did not remain significantly associated with SGA10 after adjusting for confounders (P=0.06). PlGF was significantly lower in SGA10 pregnancies (P=0.02) and remained significant in adjusted models, but failed to significantly improve the predictive performance of the models as measured by AUC (P>0.3). PP13 was not associated with SGA10 (P=0.99). Conclusions Direct assessment of placental size and shape with 3-dimensional ultrasound can serve as the foundation upon which to build a multivariable model for the early prediction of SGA.

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First trimester screening of maternal placental protein 13 for predicting preeclampsia and small for gestational age: In-house study and systematic review

Cited by 32 publications

References 33 publications

Relationship between first-trimester serum placental protein-13 and maternal characteristics, placental Doppler studies and pregnancy outcome

Relationship between first-trimester serum placental protein-13 and maternal characteristics, placental Doppler studies and pregnancy outcome

Prediction of pre‐eclampsia: review of reviews

First-trimester placental ultrasound and maternal serum markers as predictors of small-for-gestational-age infants

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