Comparison of screening for pre-eclampsia at 31-34 weeks' gestation by sFlt-1/PlGF ratio and a method combining maternal factors with sFlt-1 and PlGF
Journal article
Tan, M.Y., Wright, D., Koutoulas, L., Akolekar, R. and Nicolaides, K.H. 2017. Comparison of screening for pre-eclampsia at 31-34 weeks' gestation by sFlt-1/PlGF ratio and a method combining maternal factors with sFlt-1 and PlGF. Ultrasound in Obstetrics and Gynecology. 49 (2), pp. 201-208. https://doi.org/10.1002/uog.17307
Authors | Tan, M.Y., Wright, D., Koutoulas, L., Akolekar, R. and Nicolaides, K.H. |
---|---|
Abstract | Objective: To estimate the patient-specific risk of preeclampsia (PE) at 31-34 weeks’ gestation by a combination of maternal characteristics and medical history with multiple of the median (MoM) values of serum placental growth factor (PLGF) and serum soluble fms-like tyrosine kinase-1 (sFLT-1) and compare the performance of screening to that achieved by the sFLT-1 to PLGF ratio. Methods: This was a prospective observational study in women attending for a third-trimester ultrasound scan at 31-34 weeks as part of routine pregnancy care. We estimated the performance of screening of PE with delivery within four weeks of assessment (PE at <4 weeks) and PE from four weeks after assessment and up to 40 weeks’ gestation (PE at 4w-40GW) in screening by the sFLT-1 to PLGF ratio and by a to PLGF ratio and by a method utilizing Bayes theorem to combine maternal factors and MoM values of sFLT-1 and PLGF. The significance of difference in performance of screening between the method utilising Bayes theorem and that of the sFLT-1 to PLGF ratio was assessed by comparison of the areas under the receiver operating characteristic curves (AUROC). Results: The study population of 8,063 singleton pregnancies included 231 (2.9%) that subsequently developed PE. In the prediction of delivery with PE at <4 weeks the performance of the method utilising Bayes theorem was similar to that of the sFLT-1 to PLGF (AUROC: 0.987, 95%CI 0.979-0.995 vs. 0.988, 95%CI: 0.981-0.994; p=0.961). and at fixed fixed screen positive rate (SPR) of 3.9% the detection rate (DR) was 87.1% for both methods. In contrast, the performance of screening for delivery with PE at 4w-40GW was better with the method utilising Bayes theorem than with the sFLT-1 to PLGF ratio Conclusion: At 31-34 weeks’ gestation the performance of screening for PE at <4 weeks from assessment by the method utilising Bayes theorem is similar to that of the sFLT-1 to |
Keywords | Placental growth factor; Soluble fms-like tyrosine kinase-1; Preeclampsia; Pyramid of antenatal care |
Year | 2017 |
Journal | Ultrasound in Obstetrics and Gynecology |
Journal citation | 49 (2), pp. 201-208 |
Publisher | Wiley |
ISSN | 1469-0705 |
Digital Object Identifier (DOI) | https://doi.org/10.1002/uog.17307 |
Official URL | https://pubmed.ncbi.nlm.nih.gov/27671370/ |
Publication dates | |
Online | 27 Sep 2016 |
Publication process dates | |
Accepted | 15 Sep 2016 |
Deposited | 10 Jun 2020 |
Accepted author manuscript | |
Output status | Published |
References | 1. Maynard SE, Min JY, Merchan J, Maynard SE, Min JY, Merchan J, Lim KH, |
https://repository.canterbury.ac.uk/item/8vq37/comparison-of-screening-for-pre-eclampsia-at-31-34-weeks-gestation-by-sflt-1-plgf-ratio-and-a-method-combining-maternal-factors-with-sflt-1-and-plgf
Download files
Accepted author manuscript
75
total views61
total downloads1
views this month0
downloads this month