School of Computing and Mathematics, Plymouth University, Plymouth, UK.
Fetal Diagn Ther. 2012;32(3):171-8. doi: 10.1159/000338470. Epub 2012 Jul 27.
It was the aim of this study to develop models for the prediction of preeclampsia (PE) based on maternal characteristics and biophysical markers at 11-13 weeks' gestation in which gestation at the time of delivery for PE is treated as a continuous variable.
This was a screening study of singleton pregnancies at 11-13 weeks including 1,426 (2.4%) cases that subsequently developed PE and 57,458 cases that were unaffected by PE. We developed a survival time model for the time of delivery for PE in which Bayes' theorem was used to combine the prior information from maternal characteristics with the uterine artery pulsatility index (PI) and the mean arterial pressure (MAP), using multiple of the median values.
The risk for PE increased with maternal age, weight, Afro-Caribbean and South Asian racial origin, previous pregnancy with PE, conception by in vitro fertilization and a medical history of chronic hypertension, type 2 diabetes mellitus as well as systemic lupus erythematosus or antiphospholipid syndrome. In pregnancies with PE, there was an inverse correlation between multiple of the median values of the uterine artery PI and MAP with gestational age at delivery. Screening by maternal characteristics, uterine artery PI and MAP detected 90% of PE cases requiring delivery before 34 weeks and 57% of all PE cases at a fixed false-positive rate of 10%.
A new model has been developed for effective first-trimester screening for PE.
本研究旨在建立一种预测子痫前期（PE）的模型，该模型基于 11-13 孕周的产妇特征和生物物理标志物，其中分娩时的妊娠时间被视为连续变量。
这是一项对 11-13 孕周单胎妊娠的筛查研究，其中包括 1426 例（2.4%）随后发生 PE 的病例和 57458 例未受 PE 影响的病例。我们建立了一个 PE 分娩时间的生存时间模型，其中贝叶斯定理用于将产妇特征的先验信息与子宫动脉搏动指数（PI）和平均动脉压（MAP）结合起来，使用中位数的倍数。
PE 的风险随着产妇年龄、体重、非裔加勒比和南亚种族、既往有 PE 的妊娠、体外受精受孕以及慢性高血压、2 型糖尿病以及系统性红斑狼疮或抗磷脂综合征的病史而增加。在患有 PE 的妊娠中，子宫动脉 PI 和 MAP 的中位数倍数与分娩时的孕龄呈负相关。通过产妇特征、子宫动脉 PI 和 MAP 进行筛查，可以在固定的假阳性率为 10%的情况下，检测出 90%需要在 34 周前分娩的 PE 病例和 57%的所有 PE 病例。
已经开发出一种新的模型，用于有效的早孕期 PE 筛查。
