3 years ago

First trimester screening for pre-eclampsia in Chinese pregnancies: Case control study

Kwok Ming Law, Yuen Ha Ting, Lai Wa Law, Yvonne Kwun Yue Cheng, Daljit Singh Sahota, Tak Yeung Leung
Objective To assess the potential of screening for pre-eclampsia (PE) in a Chinese population. Design Case Control Study. Setting Teaching Hospital in Hong Kong. Population 3,330 women having a viable singleton pregnancy attending 1st trimester Down syndrome screening. Methods Mean arterial pressure (MAP), bilateral uterine artery pulsatility index (UtA-PI), and placental growth factor (PlGF) were measured. Screening markers were transformed to multiple of the gestational median (MoM) and adjusted for maternal and pregnancy characteristics. MoM distributions in PE and non-PE pregnancies were compared published expected values. PE screening performance was assessed using area under receiver operating curves (AUROC). Main Outcome Measures PE detection rate. Results 30 (0.9%) women developed either early (<34 weeks) or late (≥34 weeks) onset PE. MAP was dependent on maternal BMI, UtA-PI on fetal crown rump length, UtA-PSV on maternal age and gestation and PlGF on gestation in non-PE pregnancies. MoMs distributions determined using published Fetal Medicine Foundation models were significantly deviated from 1 MoM for both MAP (p<0.0001), PI (p<0.0001) but not PlGF (p=0.52) in Non-PE pregnancies, whilst PlGF MoM distributions in those who developed early as opposed to late onset PE were significantly higher (p=<0.05). AUROC for any PE using multiple markers was 0.72 (95% CI 0.64 – 0.81) with detection rates of 72 and 55% for early and late PE for a 10% false positive rate. Conclusions Detection rates for PE in our Chinese population were lower than the expected 90%-95% even after adjusting MoMs for local women's characteristics. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/1471-0528.14970

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