Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
Fetal Diagn Ther. 2013;33(1):16-27. doi: 10.1159/000341712. Epub 2012 Sep 13.
To combine a specific algorithm for small for gestational age (SGA) without preeclampsia (PE) and another algorithm for PE in the prediction of SGA and PE.
This was a screening study of singleton pregnancies at 11-13 weeks including 1,426 (2.3%) that subsequently developed PE, 3,168 (5.1%) that delivered SGA neonates and 57,458 that were unaffected by PE and SGA. We developed a prediction algorithm for SGA requiring delivery before 37 weeks' gestation (preterm-SGA) from maternal characteristics, uterine artery pulsatility index, mean arterial pressure, serum pregnancy-associated plasma protein-A and placental growth factor multiple of the median values. We then examined the performance of this algorithm individually and in combination with a previously reported algorithm for early-PE in the prediction of SGA and PE.
When screen positivity was defined by risk cutoff of 1:200 using the algorithm for early-PE and the risk cutoff of 1:150 using the algorithm for preterm-SGA, the false positive rate was 10.9% and the detection rates of early-PE, late-PE, preterm-SGA and term-SGA were 95.3, 45.6, 55.5 and 44.3%, respectively.
Effective first-trimester screening for early-PE and preterm-SGA can be provided by the combined use of the specific algorithms.
结合用于预测小于胎龄儿（SGA）和子痫前期（PE）的特定无先兆子痫（PE）SGA 算法和另一个用于预测 PE 的算法。
这是一项在 11-13 周进行的单胎妊娠筛查研究，其中包括 1426 例（2.3%）随后发生 PE、3168 例（5.1%）分娩 SGA 新生儿和 57458 例未受 PE 和 SGA 影响的患者。我们从母体特征、子宫动脉搏动指数、平均动脉压、血清妊娠相关血浆蛋白-A 和胎盘生长因子中位数倍数中开发了一种预测算法，用于预测需要在 37 周前分娩的 SGA（早产-SGA）。然后，我们单独检查了该算法的性能，并将其与先前报道的用于预测 SGA 和 PE 的早期 PE 算法相结合。
当使用早期 PE 算法的风险截止值 1:200 和使用早产-SGA 算法的风险截止值 1:150 定义阳性筛查时，假阳性率为 10.9%，早期 PE、晚期 PE、早产-SGA 和足月 SGA 的检出率分别为 95.3%、45.6%、55.5%和 44.3%。
通过使用特定算法的联合应用，可以为早期 PE 和早产-SGA 提供有效的早期筛查。
