Article ; Online: Pre-eclampsia screening in Denmark (PRESIDE): national validation study.
2023 Volume 61, Issue 6, Page(s) 682–690
Abstract: Objectives: To investigate the predictive performance of the Fetal Medicine Foundation (FMF) first-trimester screening algorithm for pre-eclampsia in a Danish population and compare screening performance with that of the current Danish strategy, which ... ...
| Abstract | Objectives: To investigate the predictive performance of the Fetal Medicine Foundation (FMF) first-trimester screening algorithm for pre-eclampsia in a Danish population and compare screening performance with that of the current Danish strategy, which is based on maternal risk factors. Methods: This was a prospective study of women with a singleton pregnancy attending for their first-trimester ultrasound scan and screening for aneuploidies at six Danish university hospitals between May 2019 and December 2020. Prenatal data on maternal characteristics and medical history were recorded, and measurements of mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), serum pregnancy-associated plasma protein-A (PAPP-A) and serum placental growth factor (PlGF) were collected without performing a risk assessment for pre-eclampsia. Information on acetylsalicylic acid use was recorded. After delivery, pregnancy outcome, including gestational age at delivery and pre-eclampsia diagnosis, was recorded. Pre-eclampsia risk assessment for each woman was calculated blinded to outcome using the FMF screening algorithm following adjustment to the Danish population. Detection rates (DRs) of the FMF algorithm were calculated for a fixed screen-positive rate (SPR) of 10% and for the SPR achieved in the current Danish screening. Results: A total of 8783 pregnant women were included, with a median age of 30.8 (interquartile range (IQR), 28.1-33.9) years. The majority were white (95%), naturally conceiving (90%), non-smokers (97%) and had no family history of pre-eclampsia (96%). The median body mass index was 23.4 (IQR, 21.2-26.6) kg/m Conclusion: In this large Danish multicenter study, the FMF algorithm based on maternal characteristics, MAP, UtA-PI, PlGF and PAPP-A predicted 77.4% of cases with pre-eclampsia with delivery < 34 weeks and 66.8% of cases with pre-eclampsia with delivery < 37 weeks of gestation at a SPR of 10%, suggesting that the performance of the algorithm in a Danish cohort matches that in other populations. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. |
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| MeSH term(s) | Pregnancy ; Female ; Humans ; Prenatal Diagnosis ; Pre-Eclampsia/epidemiology ; Prospective Studies ; Pregnancy-Associated Plasma Protein-A ; Placenta Growth Factor ; Arterial Pressure ; Uterine Artery/diagnostic imaging ; Biomarkers ; Pulsatile Flow ; Denmark/epidemiology |
| Chemical Substances | Pregnancy-Associated Plasma Protein-A (EC 3.4.24.-) ; Placenta Growth Factor (144589-93-5) ; Biomarkers |
| Language | English |
| Publishing date | 2023-05-05 |
| Publishing country | England |
| Document type | Multicenter Study ; Journal Article |
| ZDB-ID | 1073183-0 |
| ISSN | 1469-0705 ; 0960-7692 |
| ISSN (online) | 1469-0705 |
| ISSN | 0960-7692 |
| DOI | 10.1002/uog.26183 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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