Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD.
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD.
Am J Obstet Gynecol. 2014 Nov;211(5):514.e1-7. doi: 10.1016/j.ajog.2014.04.018. Epub 2014 Apr 15.
To derive a prediction rule for preeclampsia and early onset preeclampsia requiring delivery <34 weeks using first trimester maternal, ultrasound, and serum markers.
Prospective cohort study of women enrolled at first trimester screening. Maternal history, demographics, anthropometry, ultrasound parameters, and serum analytes were compared between women with preeclampsia and normal outcome. The prediction rule was derived by Lasso logistic regression analysis.
In 2441 women, 108 (4.4%) women developed preeclampsia, and 18 (0.7%) early preeclampsia. Nulliparity, prior hypertension, diabetes, prior preeclampsia, mean arterial pressure, and the log pregnancy-associate pregnancy protein-A multiples of the median were primary risk factors. Prediction rules for preeclampsia/early preeclampsia had an area under the curve of 0.82/0.83 respectively. Preeclampsia was predicted with 49% sensitivity and early preeclampsia with 55% sensitivity for a 10% false positive rate.
First trimester prediction rules using parameters currently available at first trimester screening identify a significant proportion of women with subsequent preeclampsia.
利用孕早期的母体、超声和血清标志物，建立预测子痫前期和需在 34 周前分娩的早发型子痫前期的预测规则。
对在孕早期筛查时入组的女性进行前瞻性队列研究。比较子痫前期患者与正常结局患者的母体病史、人口统计学、人体测量学、超声参数和血清分析物。通过 Lasso 逻辑回归分析得出预测规则。
在 2441 名女性中，有 108 名（4.4%）女性发生子痫前期，18 名（0.7%）为早发型子痫前期。初产妇、既往高血压、糖尿病、既往子痫前期、平均动脉压和妊娠相关蛋白 A 对数的中位数倍数是主要的危险因素。子痫前期/早发型子痫前期的预测规则的曲线下面积分别为 0.82/0.83。预测子痫前期的敏感性为 49%，预测早发型子痫前期的敏感性为 55%，假阳性率为 10%。
使用目前在孕早期筛查中可获得的参数建立的孕早期预测规则可识别出相当一部分随后发生子痫前期的女性。
