The potential of repeated mean arterial pressure measurements for predicting early‐ and late‐onset pre‐eclampsia in twin pregnancies: Prediction model study
Objective To investigate the contribution of longitudinal mean arterial pressure (MAP) measurement during the first, second, and third trimesters of twin pregnancies to the prediction of pre‐eclampsia. Methods A retrospective cohort study was conducted on women with twin pregnancies. Historical data...
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| Veröffentlicht in: | International journal of gynecology and obstetrics 2025-01, Vol.168 (1), p.196-204 |
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| container_title | International journal of gynecology and obstetrics |
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| creator | He, Yunjiang Xie, Jinliang Guo, Yuna Ma, Jue Wang, Xiaojin Lv, Yao Wu, Siqi Wei, Siying Xie, Xianjing Wang, Bingshun |
| description | Objective
To investigate the contribution of longitudinal mean arterial pressure (MAP) measurement during the first, second, and third trimesters of twin pregnancies to the prediction of pre‐eclampsia.
Methods
A retrospective cohort study was conducted on women with twin pregnancies. Historical data between 2019 and 2021 were analyzed, including maternal characteristics and mean artery pressure measurements were obtained at 11–13, 22–24, and 28–33 weeks of gestation. The outcome measures included pre‐eclampsia with delivery |
| doi_str_mv | 10.1002/ijgo.15825 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3085689294</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3085689294</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2185-d7eba456a0d25afd1818d92d69d2e0ff75eb2196b9da185d4f0b228bc50323273</originalsourceid><addsrcrecordid>eNp9kU1u2zAQRomiQe0k3fQABZdFACUkZZpid0WQXxhIFs5aoMSRS4MiVZJC4F2PkDP0aDlJqdrNMhvOYL7Ht_kQ-kLJOSWEXZjtxp9TXjH-Ac1pJWRRLoT8iOY5JIVgks3QcYxbQggVlH5Cs1ISwQTlc_Rn_RPw4BO4ZJTFvsMBBlAJNO5BOaxCgjAlQ4AYxwDTeZp9_hFx58OUaNMm4zYYVLC7198vWDmNbbbk3bsIaYLyDq1V_RCNwsbh9JyffN845VoD8Tt-PJi8w73XYHFMo96doqNO2QifD_MEPV1frS9vi9XDzd3lj1XRMlrxQgto1IIvFdGMq07TilZaMr2UmgHpOsGhYVQuG6lV5vWiIw1jVdNyUrKSifIEfdt7h-B_jRBT3ZvYgrXKgR9jXZKKLyvJ5CKjZ3u0DT7GAF09BNOrsKspqadO6qmT-l8nGf568I5ND_oN_V9CBugeeDYWdu-o6rv7m4e99C_Yf54J</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3085689294</pqid></control><display><type>article</type><title>The potential of repeated mean arterial pressure measurements for predicting early‐ and late‐onset pre‐eclampsia in twin pregnancies: Prediction model study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>He, Yunjiang ; Xie, Jinliang ; Guo, Yuna ; Ma, Jue ; Wang, Xiaojin ; Lv, Yao ; Wu, Siqi ; Wei, Siying ; Xie, Xianjing ; Wang, Bingshun</creator><creatorcontrib>He, Yunjiang ; Xie, Jinliang ; Guo, Yuna ; Ma, Jue ; Wang, Xiaojin ; Lv, Yao ; Wu, Siqi ; Wei, Siying ; Xie, Xianjing ; Wang, Bingshun</creatorcontrib><description>Objective
To investigate the contribution of longitudinal mean arterial pressure (MAP) measurement during the first, second, and third trimesters of twin pregnancies to the prediction of pre‐eclampsia.
Methods
A retrospective cohort study was conducted on women with twin pregnancies. Historical data between 2019 and 2021 were analyzed, including maternal characteristics and mean artery pressure measurements were obtained at 11–13, 22–24, and 28–33 weeks of gestation. The outcome measures included pre‐eclampsia with delivery <34 and ≥34 weeks of gestation. Models were developed using logistic regression, and predictive performance was evaluated using the area under the curve, detection rate at a given false‐positive rate of 10%, and calibration plots. Internal validation was conducted via bootstrapping.
Results
A total of 943 twin pregnancies, including 36 (3.82%) women who experienced early‐onset pre‐eclampsia and 93 (9.86%) who developed late‐onset pre‐eclampsia, were included in this study. To forecast pre‐eclampsia during the third trimester, the most accurate prediction for early‐onset pre‐eclampsia resulted from a combination of maternal factors and MAP measured during this trimester. The optimal predictive model for late‐onset pre‐eclampsia includes maternal factors and MAP data collected during the second and third trimesters. The areas under the curve were 0.937 (95% confidence interval [CI] 0.894–0.981) and 0.887 (95% CI 0.852–0.921), respectively. The corresponding detection rates were 83.33% (95% CI 66.53%–93.04%) for early‐onset pre‐eclampsia and 68.82% (95% CI 58.26%–77.80%) for late‐onset pre‐eclampsia.
Conclusion
Repeated measurements of MAP during pregnancy significantly improved the accuracy of late‐onset pre‐eclampsia prediction in twin pregnancies. The integration of longitudinal data into pre‐eclampsia screening may be an effective and valuable strategy.
Synopsis
Serial MAP values outperform single‐time‐point measurements for predicting late‐onset pre‐eclampsia, yielding higher AUCs and detection rates.</description><identifier>ISSN: 0020-7292</identifier><identifier>ISSN: 1879-3479</identifier><identifier>EISSN: 1879-3479</identifier><identifier>DOI: 10.1002/ijgo.15825</identifier><identifier>PMID: 39072715</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Arterial Pressure - physiology ; Blood Pressure Determination - methods ; Female ; Humans ; Logistic Models ; mean arterial pressure ; multiple pregnancy ; Pre-Eclampsia - diagnosis ; Pre-Eclampsia - physiopathology ; prediction ; Predictive Value of Tests ; Pregnancy ; Pregnancy, Twin ; pre‐eclampsia ; repeat measurements ; Retrospective Studies ; screening ; twins</subject><ispartof>International journal of gynecology and obstetrics, 2025-01, Vol.168 (1), p.196-204</ispartof><rights>2024 International Federation of Gynecology and Obstetrics.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2185-d7eba456a0d25afd1818d92d69d2e0ff75eb2196b9da185d4f0b228bc50323273</cites><orcidid>0009-0004-0326-3954 ; 0000-0002-1912-7939 ; 0000-0002-0435-2543 ; 0009-0003-0295-473X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fijgo.15825$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fijgo.15825$$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/39072715$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>He, Yunjiang</creatorcontrib><creatorcontrib>Xie, Jinliang</creatorcontrib><creatorcontrib>Guo, Yuna</creatorcontrib><creatorcontrib>Ma, Jue</creatorcontrib><creatorcontrib>Wang, Xiaojin</creatorcontrib><creatorcontrib>Lv, Yao</creatorcontrib><creatorcontrib>Wu, Siqi</creatorcontrib><creatorcontrib>Wei, Siying</creatorcontrib><creatorcontrib>Xie, Xianjing</creatorcontrib><creatorcontrib>Wang, Bingshun</creatorcontrib><title>The potential of repeated mean arterial pressure measurements for predicting early‐ and late‐onset pre‐eclampsia in twin pregnancies: Prediction model study</title><title>International journal of gynecology and obstetrics</title><addtitle>Int J Gynaecol Obstet</addtitle><description>Objective
To investigate the contribution of longitudinal mean arterial pressure (MAP) measurement during the first, second, and third trimesters of twin pregnancies to the prediction of pre‐eclampsia.
Methods
A retrospective cohort study was conducted on women with twin pregnancies. Historical data between 2019 and 2021 were analyzed, including maternal characteristics and mean artery pressure measurements were obtained at 11–13, 22–24, and 28–33 weeks of gestation. The outcome measures included pre‐eclampsia with delivery <34 and ≥34 weeks of gestation. Models were developed using logistic regression, and predictive performance was evaluated using the area under the curve, detection rate at a given false‐positive rate of 10%, and calibration plots. Internal validation was conducted via bootstrapping.
Results
A total of 943 twin pregnancies, including 36 (3.82%) women who experienced early‐onset pre‐eclampsia and 93 (9.86%) who developed late‐onset pre‐eclampsia, were included in this study. To forecast pre‐eclampsia during the third trimester, the most accurate prediction for early‐onset pre‐eclampsia resulted from a combination of maternal factors and MAP measured during this trimester. The optimal predictive model for late‐onset pre‐eclampsia includes maternal factors and MAP data collected during the second and third trimesters. The areas under the curve were 0.937 (95% confidence interval [CI] 0.894–0.981) and 0.887 (95% CI 0.852–0.921), respectively. The corresponding detection rates were 83.33% (95% CI 66.53%–93.04%) for early‐onset pre‐eclampsia and 68.82% (95% CI 58.26%–77.80%) for late‐onset pre‐eclampsia.
Conclusion
Repeated measurements of MAP during pregnancy significantly improved the accuracy of late‐onset pre‐eclampsia prediction in twin pregnancies. The integration of longitudinal data into pre‐eclampsia screening may be an effective and valuable strategy.
Synopsis
Serial MAP values outperform single‐time‐point measurements for predicting late‐onset pre‐eclampsia, yielding higher AUCs and detection rates.</description><subject>Adult</subject><subject>Arterial Pressure - physiology</subject><subject>Blood Pressure Determination - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>mean arterial pressure</subject><subject>multiple pregnancy</subject><subject>Pre-Eclampsia - diagnosis</subject><subject>Pre-Eclampsia - physiopathology</subject><subject>prediction</subject><subject>Predictive Value of Tests</subject><subject>Pregnancy</subject><subject>Pregnancy, Twin</subject><subject>pre‐eclampsia</subject><subject>repeat measurements</subject><subject>Retrospective Studies</subject><subject>screening</subject><subject>twins</subject><issn>0020-7292</issn><issn>1879-3479</issn><issn>1879-3479</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1u2zAQRomiQe0k3fQABZdFACUkZZpid0WQXxhIFs5aoMSRS4MiVZJC4F2PkDP0aDlJqdrNMhvOYL7Ht_kQ-kLJOSWEXZjtxp9TXjH-Ac1pJWRRLoT8iOY5JIVgks3QcYxbQggVlH5Cs1ISwQTlc_Rn_RPw4BO4ZJTFvsMBBlAJNO5BOaxCgjAlQ4AYxwDTeZp9_hFx58OUaNMm4zYYVLC7198vWDmNbbbk3bsIaYLyDq1V_RCNwsbh9JyffN845VoD8Tt-PJi8w73XYHFMo96doqNO2QifD_MEPV1frS9vi9XDzd3lj1XRMlrxQgto1IIvFdGMq07TilZaMr2UmgHpOsGhYVQuG6lV5vWiIw1jVdNyUrKSifIEfdt7h-B_jRBT3ZvYgrXKgR9jXZKKLyvJ5CKjZ3u0DT7GAF09BNOrsKspqadO6qmT-l8nGf568I5ND_oN_V9CBugeeDYWdu-o6rv7m4e99C_Yf54J</recordid><startdate>202501</startdate><enddate>202501</enddate><creator>He, Yunjiang</creator><creator>Xie, Jinliang</creator><creator>Guo, Yuna</creator><creator>Ma, Jue</creator><creator>Wang, Xiaojin</creator><creator>Lv, Yao</creator><creator>Wu, Siqi</creator><creator>Wei, Siying</creator><creator>Xie, Xianjing</creator><creator>Wang, Bingshun</creator><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><orcidid>https://orcid.org/0009-0004-0326-3954</orcidid><orcidid>https://orcid.org/0000-0002-1912-7939</orcidid><orcidid>https://orcid.org/0000-0002-0435-2543</orcidid><orcidid>https://orcid.org/0009-0003-0295-473X</orcidid></search><sort><creationdate>202501</creationdate><title>The potential of repeated mean arterial pressure measurements for predicting early‐ and late‐onset pre‐eclampsia in twin pregnancies: Prediction model study</title><author>He, Yunjiang ; Xie, Jinliang ; Guo, Yuna ; Ma, Jue ; Wang, Xiaojin ; Lv, Yao ; Wu, Siqi ; Wei, Siying ; Xie, Xianjing ; Wang, Bingshun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2185-d7eba456a0d25afd1818d92d69d2e0ff75eb2196b9da185d4f0b228bc50323273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Adult</topic><topic>Arterial Pressure - physiology</topic><topic>Blood Pressure Determination - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>mean arterial pressure</topic><topic>multiple pregnancy</topic><topic>Pre-Eclampsia - diagnosis</topic><topic>Pre-Eclampsia - physiopathology</topic><topic>prediction</topic><topic>Predictive Value of Tests</topic><topic>Pregnancy</topic><topic>Pregnancy, Twin</topic><topic>pre‐eclampsia</topic><topic>repeat measurements</topic><topic>Retrospective Studies</topic><topic>screening</topic><topic>twins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>He, Yunjiang</creatorcontrib><creatorcontrib>Xie, Jinliang</creatorcontrib><creatorcontrib>Guo, Yuna</creatorcontrib><creatorcontrib>Ma, Jue</creatorcontrib><creatorcontrib>Wang, Xiaojin</creatorcontrib><creatorcontrib>Lv, Yao</creatorcontrib><creatorcontrib>Wu, Siqi</creatorcontrib><creatorcontrib>Wei, Siying</creatorcontrib><creatorcontrib>Xie, Xianjing</creatorcontrib><creatorcontrib>Wang, Bingshun</creatorcontrib><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>International journal of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>He, Yunjiang</au><au>Xie, Jinliang</au><au>Guo, Yuna</au><au>Ma, Jue</au><au>Wang, Xiaojin</au><au>Lv, Yao</au><au>Wu, Siqi</au><au>Wei, Siying</au><au>Xie, Xianjing</au><au>Wang, Bingshun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The potential of repeated mean arterial pressure measurements for predicting early‐ and late‐onset pre‐eclampsia in twin pregnancies: Prediction model study</atitle><jtitle>International journal of gynecology and obstetrics</jtitle><addtitle>Int J Gynaecol Obstet</addtitle><date>2025-01</date><risdate>2025</risdate><volume>168</volume><issue>1</issue><spage>196</spage><epage>204</epage><pages>196-204</pages><issn>0020-7292</issn><issn>1879-3479</issn><eissn>1879-3479</eissn><abstract>Objective
To investigate the contribution of longitudinal mean arterial pressure (MAP) measurement during the first, second, and third trimesters of twin pregnancies to the prediction of pre‐eclampsia.
Methods
A retrospective cohort study was conducted on women with twin pregnancies. Historical data between 2019 and 2021 were analyzed, including maternal characteristics and mean artery pressure measurements were obtained at 11–13, 22–24, and 28–33 weeks of gestation. The outcome measures included pre‐eclampsia with delivery <34 and ≥34 weeks of gestation. Models were developed using logistic regression, and predictive performance was evaluated using the area under the curve, detection rate at a given false‐positive rate of 10%, and calibration plots. Internal validation was conducted via bootstrapping.
Results
A total of 943 twin pregnancies, including 36 (3.82%) women who experienced early‐onset pre‐eclampsia and 93 (9.86%) who developed late‐onset pre‐eclampsia, were included in this study. To forecast pre‐eclampsia during the third trimester, the most accurate prediction for early‐onset pre‐eclampsia resulted from a combination of maternal factors and MAP measured during this trimester. The optimal predictive model for late‐onset pre‐eclampsia includes maternal factors and MAP data collected during the second and third trimesters. The areas under the curve were 0.937 (95% confidence interval [CI] 0.894–0.981) and 0.887 (95% CI 0.852–0.921), respectively. The corresponding detection rates were 83.33% (95% CI 66.53%–93.04%) for early‐onset pre‐eclampsia and 68.82% (95% CI 58.26%–77.80%) for late‐onset pre‐eclampsia.
Conclusion
Repeated measurements of MAP during pregnancy significantly improved the accuracy of late‐onset pre‐eclampsia prediction in twin pregnancies. The integration of longitudinal data into pre‐eclampsia screening may be an effective and valuable strategy.
Synopsis
Serial MAP values outperform single‐time‐point measurements for predicting late‐onset pre‐eclampsia, yielding higher AUCs and detection rates.</abstract><cop>United States</cop><pmid>39072715</pmid><doi>10.1002/ijgo.15825</doi><tpages>9</tpages><orcidid>https://orcid.org/0009-0004-0326-3954</orcidid><orcidid>https://orcid.org/0000-0002-1912-7939</orcidid><orcidid>https://orcid.org/0000-0002-0435-2543</orcidid><orcidid>https://orcid.org/0009-0003-0295-473X</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0020-7292 |
| ispartof | International journal of gynecology and obstetrics, 2025-01, Vol.168 (1), p.196-204 |
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| language | eng |
| recordid | cdi_proquest_miscellaneous_3085689294 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Arterial Pressure - physiology Blood Pressure Determination - methods Female Humans Logistic Models mean arterial pressure multiple pregnancy Pre-Eclampsia - diagnosis Pre-Eclampsia - physiopathology prediction Predictive Value of Tests Pregnancy Pregnancy, Twin pre‐eclampsia repeat measurements Retrospective Studies screening twins |
| title | The potential of repeated mean arterial pressure measurements for predicting early‐ and late‐onset pre‐eclampsia in twin pregnancies: Prediction model study |
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