Clinical evaluation of a first trimester algorithm predicting the risk of hypertensive disease of pregnancy
Background The aim of this study is to validate the Fetal Medicine Foundation (FMF) multiple logistic regression algorithm for prediction of risk of pre‐eclampsia in an Australian population. This model, which predicts risk using the population rate of pre‐eclampsia, a variety of demographic factors...
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| Veröffentlicht in: | Australian & New Zealand journal of obstetrics & gynaecology 2013-12, Vol.53 (6), p.532-539 |
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| container_title | Australian & New Zealand journal of obstetrics & gynaecology |
| container_volume | 53 |
| creator | Park, Felicity J. Leung, Constance H.Y. Poon, Leona C.Y. Williams, Paul F. Rothwell, Samantha J. Hyett, Jon A. |
| description | Background
The aim of this study is to validate the Fetal Medicine Foundation (FMF) multiple logistic regression algorithm for prediction of risk of pre‐eclampsia in an Australian population. This model, which predicts risk using the population rate of pre‐eclampsia, a variety of demographic factors, mean maternal arterial blood pressure (MAP), uterine artery PI (UtA PI) and pregnancy‐associated plasma protein A (PAPP‐A), has been shown to predict early‐onset pre‐eclampsia (delivery prior to 34 weeks) in 95% of women at a 10% false‐positive rate.
Methods
All women who attended first trimester screening at the Royal Prince Alfred Hospital had their body mass index (BMI), MAP and UtA PI assessed in addition to factors traditionally used to assess aneuploidy (including PAPP‐A MoM). After delivery, risks of early‐onset (delivery prior to 34 weeks) pre‐eclampsia, late pre‐eclampsia and gestational hypertension were calculated using the FMF risk algorithm.
Results
A total of 3099 women were screened and delivered locally. 3066 (98.9%) women had all data to perform pre‐eclampsia screening available. This included 3014 (98.3%) women with a live birth, where risks of early pre‐eclampsia were calculated. Twelve women were delivered before 34 weeks because of early pre‐eclampsia with a prevalence of early pre‐eclampsia of 1 in 256 pregnancies. Risks generated through the use of maternal history, MAP, UtA PI and PAPP‐A detected 41.7 and 91.7% of early pre‐eclampsia at a false‐positive rate of 5 and 10%, respectively.
Conclusions
This study shows that the FMF early pre‐eclampsia algorithm is effective in an Australian population. |
| doi_str_mv | 10.1111/ajo.12126 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1464500489</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1464500489</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3636-a22f8f935ae94d1cef34b7ee6834114dca039b237b2e82bf01245f25d0ce4d7d3</originalsourceid><addsrcrecordid>eNp1kLtOwzAUhi0EgnIZeAHkEYaAb3GSESooIAQDl7JZjnPcmqZJsdNC3x6XAhtejnX0_b_sD6FDSk5pPGf6rT2ljDK5gXpUZEWSs_x1E_UIISLJpZQ7aDeEN0JokVKxjXYYL-K1ED006deucUbXGBa6nuvOtQ1uLdbYOh863Hk3hdCBx7oetd514ymeeaic6Vwzwt0YsHdhsoqMlzPwHTTBLQBXLoAOsNpHfNToxiz30ZbVdYCDn7mHnq8un_rXyd3D4KZ_fpcYLrlMNGM2twVPNRSiogYsF2UGIHMuKBWV0YQXJeNZySBnpSWUidSytCIGRJVVfA8dr3tnvn2fx9erqQsG6lo30M6DokKKNKrJi4ierFHj2xA8WDWLH9Z-qShRK7cqulXfbiN79FM7L6dQ_ZG_MiNwtgY-XA3L_5vU-e3Db2WyTrio-PMvof1EyYxnqRreD9TgcSgv-MtQpfwLEYyUOA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1464500489</pqid></control><display><type>article</type><title>Clinical evaluation of a first trimester algorithm predicting the risk of hypertensive disease of pregnancy</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Park, Felicity J. ; Leung, Constance H.Y. ; Poon, Leona C.Y. ; Williams, Paul F. ; Rothwell, Samantha J. ; Hyett, Jon A.</creator><creatorcontrib>Park, Felicity J. ; Leung, Constance H.Y. ; Poon, Leona C.Y. ; Williams, Paul F. ; Rothwell, Samantha J. ; Hyett, Jon A.</creatorcontrib><description>Background
The aim of this study is to validate the Fetal Medicine Foundation (FMF) multiple logistic regression algorithm for prediction of risk of pre‐eclampsia in an Australian population. This model, which predicts risk using the population rate of pre‐eclampsia, a variety of demographic factors, mean maternal arterial blood pressure (MAP), uterine artery PI (UtA PI) and pregnancy‐associated plasma protein A (PAPP‐A), has been shown to predict early‐onset pre‐eclampsia (delivery prior to 34 weeks) in 95% of women at a 10% false‐positive rate.
Methods
All women who attended first trimester screening at the Royal Prince Alfred Hospital had their body mass index (BMI), MAP and UtA PI assessed in addition to factors traditionally used to assess aneuploidy (including PAPP‐A MoM). After delivery, risks of early‐onset (delivery prior to 34 weeks) pre‐eclampsia, late pre‐eclampsia and gestational hypertension were calculated using the FMF risk algorithm.
Results
A total of 3099 women were screened and delivered locally. 3066 (98.9%) women had all data to perform pre‐eclampsia screening available. This included 3014 (98.3%) women with a live birth, where risks of early pre‐eclampsia were calculated. Twelve women were delivered before 34 weeks because of early pre‐eclampsia with a prevalence of early pre‐eclampsia of 1 in 256 pregnancies. Risks generated through the use of maternal history, MAP, UtA PI and PAPP‐A detected 41.7 and 91.7% of early pre‐eclampsia at a false‐positive rate of 5 and 10%, respectively.
Conclusions
This study shows that the FMF early pre‐eclampsia algorithm is effective in an Australian population.</description><identifier>ISSN: 0004-8666</identifier><identifier>EISSN: 1479-828X</identifier><identifier>DOI: 10.1111/ajo.12126</identifier><identifier>PMID: 23919594</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Algorithms ; Area Under Curve ; Arterial Pressure ; Australia ; Biomarkers - blood ; Early Diagnosis ; False Positive Reactions ; Female ; first trimester screening ; Gestational Age ; Humans ; mean arterial pressure ; Parity ; pre-eclampsia ; Pre-Eclampsia - diagnosis ; Pregnancy ; Pregnancy Trimester, First ; pregnancy-associated plasma protein-A ; Pregnancy-Associated Plasma Protein-A - metabolism ; Pulsatile Flow ; Recurrence ; Retrospective Studies ; Risk Assessment ; ROC Curve ; Uterine Artery - physiology ; uterine artery doppler</subject><ispartof>Australian & New Zealand journal of obstetrics & gynaecology, 2013-12, Vol.53 (6), p.532-539</ispartof><rights>2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists</rights><rights>2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3636-a22f8f935ae94d1cef34b7ee6834114dca039b237b2e82bf01245f25d0ce4d7d3</citedby><cites>FETCH-LOGICAL-c3636-a22f8f935ae94d1cef34b7ee6834114dca039b237b2e82bf01245f25d0ce4d7d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fajo.12126$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fajo.12126$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23919594$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Park, Felicity J.</creatorcontrib><creatorcontrib>Leung, Constance H.Y.</creatorcontrib><creatorcontrib>Poon, Leona C.Y.</creatorcontrib><creatorcontrib>Williams, Paul F.</creatorcontrib><creatorcontrib>Rothwell, Samantha J.</creatorcontrib><creatorcontrib>Hyett, Jon A.</creatorcontrib><title>Clinical evaluation of a first trimester algorithm predicting the risk of hypertensive disease of pregnancy</title><title>Australian & New Zealand journal of obstetrics & gynaecology</title><addtitle>Aust N Z J Obstet Gynaecol</addtitle><description>Background
The aim of this study is to validate the Fetal Medicine Foundation (FMF) multiple logistic regression algorithm for prediction of risk of pre‐eclampsia in an Australian population. This model, which predicts risk using the population rate of pre‐eclampsia, a variety of demographic factors, mean maternal arterial blood pressure (MAP), uterine artery PI (UtA PI) and pregnancy‐associated plasma protein A (PAPP‐A), has been shown to predict early‐onset pre‐eclampsia (delivery prior to 34 weeks) in 95% of women at a 10% false‐positive rate.
Methods
All women who attended first trimester screening at the Royal Prince Alfred Hospital had their body mass index (BMI), MAP and UtA PI assessed in addition to factors traditionally used to assess aneuploidy (including PAPP‐A MoM). After delivery, risks of early‐onset (delivery prior to 34 weeks) pre‐eclampsia, late pre‐eclampsia and gestational hypertension were calculated using the FMF risk algorithm.
Results
A total of 3099 women were screened and delivered locally. 3066 (98.9%) women had all data to perform pre‐eclampsia screening available. This included 3014 (98.3%) women with a live birth, where risks of early pre‐eclampsia were calculated. Twelve women were delivered before 34 weeks because of early pre‐eclampsia with a prevalence of early pre‐eclampsia of 1 in 256 pregnancies. Risks generated through the use of maternal history, MAP, UtA PI and PAPP‐A detected 41.7 and 91.7% of early pre‐eclampsia at a false‐positive rate of 5 and 10%, respectively.
Conclusions
This study shows that the FMF early pre‐eclampsia algorithm is effective in an Australian population.</description><subject>Algorithms</subject><subject>Area Under Curve</subject><subject>Arterial Pressure</subject><subject>Australia</subject><subject>Biomarkers - blood</subject><subject>Early Diagnosis</subject><subject>False Positive Reactions</subject><subject>Female</subject><subject>first trimester screening</subject><subject>Gestational Age</subject><subject>Humans</subject><subject>mean arterial pressure</subject><subject>Parity</subject><subject>pre-eclampsia</subject><subject>Pre-Eclampsia - diagnosis</subject><subject>Pregnancy</subject><subject>Pregnancy Trimester, First</subject><subject>pregnancy-associated plasma protein-A</subject><subject>Pregnancy-Associated Plasma Protein-A - metabolism</subject><subject>Pulsatile Flow</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>ROC Curve</subject><subject>Uterine Artery - physiology</subject><subject>uterine artery doppler</subject><issn>0004-8666</issn><issn>1479-828X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kLtOwzAUhi0EgnIZeAHkEYaAb3GSESooIAQDl7JZjnPcmqZJsdNC3x6XAhtejnX0_b_sD6FDSk5pPGf6rT2ljDK5gXpUZEWSs_x1E_UIISLJpZQ7aDeEN0JokVKxjXYYL-K1ED006deucUbXGBa6nuvOtQ1uLdbYOh863Hk3hdCBx7oetd514ymeeaic6Vwzwt0YsHdhsoqMlzPwHTTBLQBXLoAOsNpHfNToxiz30ZbVdYCDn7mHnq8un_rXyd3D4KZ_fpcYLrlMNGM2twVPNRSiogYsF2UGIHMuKBWV0YQXJeNZySBnpSWUidSytCIGRJVVfA8dr3tnvn2fx9erqQsG6lo30M6DokKKNKrJi4ierFHj2xA8WDWLH9Z-qShRK7cqulXfbiN79FM7L6dQ_ZG_MiNwtgY-XA3L_5vU-e3Db2WyTrio-PMvof1EyYxnqRreD9TgcSgv-MtQpfwLEYyUOA</recordid><startdate>201312</startdate><enddate>201312</enddate><creator>Park, Felicity J.</creator><creator>Leung, Constance H.Y.</creator><creator>Poon, Leona C.Y.</creator><creator>Williams, Paul F.</creator><creator>Rothwell, Samantha J.</creator><creator>Hyett, Jon A.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201312</creationdate><title>Clinical evaluation of a first trimester algorithm predicting the risk of hypertensive disease of pregnancy</title><author>Park, Felicity J. ; Leung, Constance H.Y. ; Poon, Leona C.Y. ; Williams, Paul F. ; Rothwell, Samantha J. ; Hyett, Jon A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3636-a22f8f935ae94d1cef34b7ee6834114dca039b237b2e82bf01245f25d0ce4d7d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Algorithms</topic><topic>Area Under Curve</topic><topic>Arterial Pressure</topic><topic>Australia</topic><topic>Biomarkers - blood</topic><topic>Early Diagnosis</topic><topic>False Positive Reactions</topic><topic>Female</topic><topic>first trimester screening</topic><topic>Gestational Age</topic><topic>Humans</topic><topic>mean arterial pressure</topic><topic>Parity</topic><topic>pre-eclampsia</topic><topic>Pre-Eclampsia - diagnosis</topic><topic>Pregnancy</topic><topic>Pregnancy Trimester, First</topic><topic>pregnancy-associated plasma protein-A</topic><topic>Pregnancy-Associated Plasma Protein-A - metabolism</topic><topic>Pulsatile Flow</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>ROC Curve</topic><topic>Uterine Artery - physiology</topic><topic>uterine artery doppler</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, Felicity J.</creatorcontrib><creatorcontrib>Leung, Constance H.Y.</creatorcontrib><creatorcontrib>Poon, Leona C.Y.</creatorcontrib><creatorcontrib>Williams, Paul F.</creatorcontrib><creatorcontrib>Rothwell, Samantha J.</creatorcontrib><creatorcontrib>Hyett, Jon A.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Australian & New Zealand journal of obstetrics & gynaecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, Felicity J.</au><au>Leung, Constance H.Y.</au><au>Poon, Leona C.Y.</au><au>Williams, Paul F.</au><au>Rothwell, Samantha J.</au><au>Hyett, Jon A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical evaluation of a first trimester algorithm predicting the risk of hypertensive disease of pregnancy</atitle><jtitle>Australian & New Zealand journal of obstetrics & gynaecology</jtitle><addtitle>Aust N Z J Obstet Gynaecol</addtitle><date>2013-12</date><risdate>2013</risdate><volume>53</volume><issue>6</issue><spage>532</spage><epage>539</epage><pages>532-539</pages><issn>0004-8666</issn><eissn>1479-828X</eissn><abstract>Background
The aim of this study is to validate the Fetal Medicine Foundation (FMF) multiple logistic regression algorithm for prediction of risk of pre‐eclampsia in an Australian population. This model, which predicts risk using the population rate of pre‐eclampsia, a variety of demographic factors, mean maternal arterial blood pressure (MAP), uterine artery PI (UtA PI) and pregnancy‐associated plasma protein A (PAPP‐A), has been shown to predict early‐onset pre‐eclampsia (delivery prior to 34 weeks) in 95% of women at a 10% false‐positive rate.
Methods
All women who attended first trimester screening at the Royal Prince Alfred Hospital had their body mass index (BMI), MAP and UtA PI assessed in addition to factors traditionally used to assess aneuploidy (including PAPP‐A MoM). After delivery, risks of early‐onset (delivery prior to 34 weeks) pre‐eclampsia, late pre‐eclampsia and gestational hypertension were calculated using the FMF risk algorithm.
Results
A total of 3099 women were screened and delivered locally. 3066 (98.9%) women had all data to perform pre‐eclampsia screening available. This included 3014 (98.3%) women with a live birth, where risks of early pre‐eclampsia were calculated. Twelve women were delivered before 34 weeks because of early pre‐eclampsia with a prevalence of early pre‐eclampsia of 1 in 256 pregnancies. Risks generated through the use of maternal history, MAP, UtA PI and PAPP‐A detected 41.7 and 91.7% of early pre‐eclampsia at a false‐positive rate of 5 and 10%, respectively.
Conclusions
This study shows that the FMF early pre‐eclampsia algorithm is effective in an Australian population.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>23919594</pmid><doi>10.1111/ajo.12126</doi><tpages>8</tpages></addata></record> |
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| identifier | ISSN: 0004-8666 |
| ispartof | Australian & New Zealand journal of obstetrics & gynaecology, 2013-12, Vol.53 (6), p.532-539 |
| issn | 0004-8666 1479-828X |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Algorithms Area Under Curve Arterial Pressure Australia Biomarkers - blood Early Diagnosis False Positive Reactions Female first trimester screening Gestational Age Humans mean arterial pressure Parity pre-eclampsia Pre-Eclampsia - diagnosis Pregnancy Pregnancy Trimester, First pregnancy-associated plasma protein-A Pregnancy-Associated Plasma Protein-A - metabolism Pulsatile Flow Recurrence Retrospective Studies Risk Assessment ROC Curve Uterine Artery - physiology uterine artery doppler |
| title | Clinical evaluation of a first trimester algorithm predicting the risk of hypertensive disease of pregnancy |
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