Primary outome: preeclampsia with subsequent delivery either early (<34 weeks’ gestation) or late (≥34 weeks’ gestation)
1068 patients were analyzed
4.3% developed preeclampsia: 1.22% with early delivery <34 weeks, and 3.09% with delivery ≥34 weeks
Using maternal characteristics, serum biomarkers and UtA-PI, the detection rate of early-onset preeclampsia was 85% with a 5% false positive rate
With the same protocol, the detection rates for preeclampsia with delivery <37 weeks were 52% (5% false positive rate) and 60% (10% false-positive rate)
Based on maternal characteristics, the detection rates for late-onset preeclampsia ≥34 weeks were 15% (5% false positive rate) and 48% (10% false positive rate), while for preeclampsia at ≥37 weeks’ gestation the detection rates were 24% and 43%, respectively
The addition of biomarkers did not improve detection rates for late-onset preeclampsia and preeclampsia with delivery at >37 weeks’ gestation
Screening for preeclampsia at 11w0d-13w6d gestation using maternal characteristics and biomarkers is associated with a high detection rate for a low false-positive rate
MSAFP contributed to detection
Screening for late-onset preeclampsia screening yields poorer results
The addition of placental volume and mean arterial pressure was of limited benefit, however, and may be due to small sample size
MAP and PlGF have been shown to helpful in other studies and EPV (which tended to ward being smaller in this study) may still be shown to be of benefit in larger data sets
This study was undertaken in the US, where testing is less centralized and ethnic and medical histories may differ from the UK
The authors conclude that based on results which are consistent with previous studies such as the ASPRE trial, a first trimester screening program can detect those at risk of early onset preeclampsia
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