Multicenter screening for pre‐eclampsia by maternal factors and biomarkers at 11–13 weeks' gestation: comparison with <scp>NICE</scp> guidelines and <scp>ACOG</scp> recommendations

O’Gorman, Neil; Wright, David; Poon, Liona C.; Rolnik, Daniel L.; Syngelaki, Argyro; Alvarado, M. De; Carbone, Ilma Floriana; Dütemeyer, Vivien; Fiolna, M.; Frick, Alexander; Karagiotis, N.; Mastrodima, S.; Matallana, Catalina De Paco; Papaioannou, George; Pazos, Andrea; Plasencia, W.; Nicolaides, Kypros H.

doi:10.1002/uog.17455

Cited by 299 publications

(261 citation statements)

References 16 publications

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“…In the USA, the American College of Obstetricians and Gynecologists (ACOG) recommends the use of aspirin in women with a history of PE in more than one pregnancy or a history of PE that resulted in delivery before 34 weeks' gestation. However, this subgroup constitutes only approximately 0.3% of all pregnancies and includes only 5% of women who develop preterm PE. Our approach to screening with the use of Bayes' theorem to combine the a‐priori risk from maternal factors with biophysical and biochemical measurements obtained at 11–13 weeks' gestation is by far superior to those of NICE and ACOG in identifying the group who would benefit from prophylactic use of aspirin.…”

Section: Discussionmentioning

confidence: 99%

ASPRE trial: performance of screening for preterm pre‐eclampsia

Rolnik

Wright

Poon

et al. 2017

Ultrasound in Obstet & Gyne

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Section: Discussionmentioning

confidence: 99%

ASPRE trial: performance of screening for preterm pre‐eclampsia

Rolnik

Wright

Poon

et al. 2017

Ultrasound in Obstet & Gyne

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312

219

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“…In the ASPRE study, these parameters were integrated together with biochemical and biophysical markers to stratify the patients at high risk for developing intermediate PE, and its prevention by aspirin [46–48]. The ASPRE study was less successful in the prediction and prevention of term PE.…”

Section: Discussionmentioning

confidence: 99%

Predicting the Risk to Develop Preeclampsia in the First Trimester Combining Promoter Variant -98A/C of LGALS13 (Placental Protein 13), Black Ethnicity, Previous Preeclampsia, Obesity, and Maternal Age

Madar-Shapiro¹,

Karady²,

Trahtenherts³

et al. 2017

Fetal Diagn Ther

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Background:LGALS13 (placental protein 13 [PP13]) promoter DNA polymorphisms was evaluated in predicting preeclampsia (PE), given PP13's effects on hypotension, angiogenesis, and immune tolerance. Methods: First-trimester plasma samples (49 term and 18 intermediate) of PE cases matched with 196 controls were collected from King's College Hospital, London, repository. Cell-free DNA was extracted and the LGALS13 exons were sequenced after PCR amplification. Expression of LGALS13 promoter reporter constructs was determined in BeWo trophoblast-like cells with luciferase assays. Adjusted odds ratio (OR) was calculated for the A/A genotype combined with maternal risk factors. Results: The A/A, A/C, and C/C genotypes in the -98 promoter position were in Hardy-Weinberg equilibrium in the control but not in the PE group (p < 0.036). The dominant A/A genotype had higher frequency in the PE group (p < 0.001). The A/C and C/C genotypes protected from PE (p < 0.032). The ORs to develop term and all PE, calculated for the A/A genotype, previous PE, body mass index (BMI) >35, black ethnicity, and maternal age >40 were 15.6 and 11.0, respectively (p < 0.001). In luciferase assays, the “-98A” promoter variant had lower expression than the “-98C” variant in non-differentiated (-13%, p = 0.04) and differentiated (-26%, p < 0.001) BeWo cells. Forskolin-induced differentiation led to a larger expression increase in the “-98C” variant than in the “-98A” variant (4.55-fold vs. 3.85-fold, p < 0.001). Conclusion: Lower LGALS13 (PP13) expression with the “A” nucleotide in the -98 promoter region position (compared to “C”) and high OR calculated for the A/A genotype in the -98A/C promoter region position, history of previous PE, BMI >35, advanced maternal age >40, and black ethnicity could serve to aid in PE prediction in the first trimester.

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“…However, the performance of such screening is poor, with detection of about 40% of preterm pre‐eclampsia cases and 33% of term pre‐eclampsia cases at a screen‐positive rate of 11% . In the USA, the American College of Obstetricians and Gynaecologists (ACOG) recommends use of aspirin for women with a history of pre‐eclampsia in more than one pregnancy or history of pre‐eclampsia requiring delivery before 34 weeks of gestation; however, this subgroup constitutes about 0.3% of all pregnancies and contains only 5% of those that would develop preterm pre‐eclampsia and 2% of term pre‐eclampsia …”

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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Multicenter screening for pre‐eclampsia by maternal factors and biomarkers at 11–13 weeks' gestation: comparison with NICE guidelines and ACOG recommendations

Abstract: Objective To compare the performance of screening for pre-eclampsia (PE) based on risk factors from medical history, as recommended by NICE and ACOG, with the method proposed by The Fetal Medicine Foundation (FMF)

Cited by 299 publications

References 16 publications

ASPRE trial: performance of screening for preterm pre‐eclampsia

ASPRE trial: performance of screening for preterm pre‐eclampsia

Predicting the Risk to Develop Preeclampsia in the First Trimester Combining Promoter Variant -98A/C of LGALS13 (Placental Protein 13), Black Ethnicity, Previous Preeclampsia, Obesity, and Maternal Age

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

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