Continuous Risk Assessment of Late and Term Preeclampsia Throughout Pregnancy: A Retrospective Cohort Study

<i>Background and Objectives</i>: To evaluate the diagnostic accuracy of widely available biomarkers longitudinally measured throughout pregnancy to predict all and term (delivery at ≥37 weeks) preeclampsia (PE). <i>Materials and Methods</i>: This is a longitudinal retrospect...

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Main Authors: Valeria Rolle, Petya Chaveeva, Ander Diaz-Navarro, Irene Fernández-Buhigas, Diana Cuenca-Gómez, Tanya Tilkova, Belén Santacruz, Teresa Pérez, Maria M. Gil
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/60/12/1909
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author Valeria Rolle
Petya Chaveeva
Ander Diaz-Navarro
Irene Fernández-Buhigas
Diana Cuenca-Gómez
Tanya Tilkova
Belén Santacruz
Teresa Pérez
Maria M. Gil
author_facet Valeria Rolle
Petya Chaveeva
Ander Diaz-Navarro
Irene Fernández-Buhigas
Diana Cuenca-Gómez
Tanya Tilkova
Belén Santacruz
Teresa Pérez
Maria M. Gil
author_sort Valeria Rolle
collection DOAJ
description <i>Background and Objectives</i>: To evaluate the diagnostic accuracy of widely available biomarkers longitudinally measured throughout pregnancy to predict all and term (delivery at ≥37 weeks) preeclampsia (PE). <i>Materials and Methods</i>: This is a longitudinal retrospective study performed at Hospital Universitario de Torrejón (Madrid, Spain) and Shterev Hospital (Sofia, Bulgaria) between August 2017 and December 2022. All pregnant women with singleton pregnancies and non-malformed live fetuses attending their routine ultrasound examination and first-trimester screening for preterm PE at 11 + 0 to 13 + 6 weeks’ gestation at the participating centers were invited to participate in a larger study for the prediction of pregnancy complications. The dataset was divided into two subsets to develop and validate a joint model of time-to-event outcome and longitudinal data, and to evaluate how the area under the receiving operating characteristic curve (AUROC) evolved with time. <i>Results</i>: 4056 pregnancies were included in the training set (59 all PE, 40 term PE) and 944 in the validation set (23 all PE, 20 term PE). For the joint model and all PE, the AUROC was 0.84 (95% CI 0.73 to 0.94) and the detection rate (DR) for a 10% screening positive rate (SPR) was 56.5 (95% CI 34.5 to 76.8). For term PE, AUROC was 0.80 (95% CI 0.69 to 0.91), and DR for a 10% SPR was 55.0 (95% CI 31.5 to 76.9). The AUROC using only information from the first trimester was 0.50 (95% CI 0.37 to 0.64) and it increased to 0.84 (0.73 to 0.94) when using all information available. <i>Conclusions</i>: Routinely measuring MAP and UtA-PI throughout pregnancy may improve the predictive prediction power for all and term-PE.
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spelling doaj-art-f49e6837f7e94c01b3cb55affc2404c32024-12-27T14:38:29ZengMDPI AGMedicina1010-660X1648-91442024-11-016012190910.3390/medicina60121909Continuous Risk Assessment of Late and Term Preeclampsia Throughout Pregnancy: A Retrospective Cohort StudyValeria Rolle0Petya Chaveeva1Ander Diaz-Navarro2Irene Fernández-Buhigas3Diana Cuenca-Gómez4Tanya Tilkova5Belén Santacruz6Teresa Pérez7Maria M. Gil8Faculty of Statistical Studies, Complutense University of Madrid, 28040 Madrid, SpainDr. Shterev Hospital, 1330 Sofia, BulgariaOntario Institute for Cancer Research, Toronto, ON M5G 0A3, CanadaObstetrics Department, Torrejón University Hospital, 28850 Madrid, SpainObstetrics Department, Torrejón University Hospital, 28850 Madrid, SpainDr. Shterev Hospital, 1330 Sofia, BulgariaObstetrics Department, Torrejón University Hospital, 28850 Madrid, SpainFaculty of Statistical Studies, Complutense University of Madrid, 28040 Madrid, SpainObstetrics Department, Torrejón University Hospital, 28850 Madrid, Spain<i>Background and Objectives</i>: To evaluate the diagnostic accuracy of widely available biomarkers longitudinally measured throughout pregnancy to predict all and term (delivery at ≥37 weeks) preeclampsia (PE). <i>Materials and Methods</i>: This is a longitudinal retrospective study performed at Hospital Universitario de Torrejón (Madrid, Spain) and Shterev Hospital (Sofia, Bulgaria) between August 2017 and December 2022. All pregnant women with singleton pregnancies and non-malformed live fetuses attending their routine ultrasound examination and first-trimester screening for preterm PE at 11 + 0 to 13 + 6 weeks’ gestation at the participating centers were invited to participate in a larger study for the prediction of pregnancy complications. The dataset was divided into two subsets to develop and validate a joint model of time-to-event outcome and longitudinal data, and to evaluate how the area under the receiving operating characteristic curve (AUROC) evolved with time. <i>Results</i>: 4056 pregnancies were included in the training set (59 all PE, 40 term PE) and 944 in the validation set (23 all PE, 20 term PE). For the joint model and all PE, the AUROC was 0.84 (95% CI 0.73 to 0.94) and the detection rate (DR) for a 10% screening positive rate (SPR) was 56.5 (95% CI 34.5 to 76.8). For term PE, AUROC was 0.80 (95% CI 0.69 to 0.91), and DR for a 10% SPR was 55.0 (95% CI 31.5 to 76.9). The AUROC using only information from the first trimester was 0.50 (95% CI 0.37 to 0.64) and it increased to 0.84 (0.73 to 0.94) when using all information available. <i>Conclusions</i>: Routinely measuring MAP and UtA-PI throughout pregnancy may improve the predictive prediction power for all and term-PE.https://www.mdpi.com/1648-9144/60/12/1909preeclampsiapreterm preeclampsiascreeningPlGFsFlt-1UtA-PI
spellingShingle Valeria Rolle
Petya Chaveeva
Ander Diaz-Navarro
Irene Fernández-Buhigas
Diana Cuenca-Gómez
Tanya Tilkova
Belén Santacruz
Teresa Pérez
Maria M. Gil
Continuous Risk Assessment of Late and Term Preeclampsia Throughout Pregnancy: A Retrospective Cohort Study
Medicina
preeclampsia
preterm preeclampsia
screening
PlGF
sFlt-1
UtA-PI
title Continuous Risk Assessment of Late and Term Preeclampsia Throughout Pregnancy: A Retrospective Cohort Study
title_full Continuous Risk Assessment of Late and Term Preeclampsia Throughout Pregnancy: A Retrospective Cohort Study
title_fullStr Continuous Risk Assessment of Late and Term Preeclampsia Throughout Pregnancy: A Retrospective Cohort Study
title_full_unstemmed Continuous Risk Assessment of Late and Term Preeclampsia Throughout Pregnancy: A Retrospective Cohort Study
title_short Continuous Risk Assessment of Late and Term Preeclampsia Throughout Pregnancy: A Retrospective Cohort Study
title_sort continuous risk assessment of late and term preeclampsia throughout pregnancy a retrospective cohort study
topic preeclampsia
preterm preeclampsia
screening
PlGF
sFlt-1
UtA-PI
url https://www.mdpi.com/1648-9144/60/12/1909
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