Department of Gynecology, Obstetrics and Reproduction, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada.
Reproduction, Mother and Child Health Unit, CHU de Québec-Université Laval Research Center, Quebec City, Quebec, Canada.
Am J Perinatol. 2019 Jul;36(9):930-935. doi: 10.1055/s-0038-1675209. Epub 2018 Nov 10.
This study aimed to estimate the performance of first-trimester uterine artery (UtA) pulsatility index (PI) for the prediction of preeclampsia (PE).
We conducted a prospective cohort study of nulliparous women with singleton gestation at 11 to 13 weeks. UtA-Doppler's was performed on both UtAs and the mean UtA-PI was reported in multiple of median (MoM) adjusted for gestational age. Using receiver operating characteristic curves and their area under the curves (AUC); we calculated the performance of UtA-PI for the prediction of PE. Proportional hazard models were used to develop prediction models combining UtA-PI and maternal characteristics.
Out of 4,676 participants with completed follow-up, 232 (4.9%) developed PE, including 202 (4.3%) term and 30 (0.6%) preterm PE. Mean UtA-PI decreased with gestational age between 11 and 13 weeks ( < 0.001). First-trimester UtA-PI was associated with preterm (AUC: 0.69; 95% CI [confidence interval]: 0.57-0.80) but not with term (AUC: 0.52; 95% CI: 0.48-0.56) PE. UtA-PI combined with maternal characteristics could predict 45% of preterm PE at a false positive rate of 10%.
First-trimester UtA-PI decreases with gestational age between 11 and 13 weeks and is associated with the risk of preterm but not term PE.
本研究旨在评估早孕期子宫动脉（UtA）搏动指数（PI）预测子痫前期（PE）的性能。
我们进行了一项前瞻性队列研究，纳入了 11 至 13 周龄、单胎妊娠的初产妇。对双侧 UtA 进行 UtA-Doppler 检查，并报告经孕周校正的平均 UtA-PI（MoM）。我们使用接收者操作特征曲线及其曲线下面积（AUC）来计算 UtA-PI 预测 PE 的性能。使用比例风险模型构建结合 UtA-PI 和母体特征的预测模型。
在完成随访的 4676 名参与者中，232 名（4.9%）发生了 PE，包括 202 名（4.3%）足月 PE 和 30 名（0.6%）早产 PE。早孕期 UtA-PI 随孕周从 11 周到 13 周逐渐降低（<0.001）。早孕期 UtA-PI 与早产（AUC：0.69；95%CI[置信区间]：0.57-0.80）相关，但与足月（AUC：0.52；95%CI：0.48-0.56）PE 无关。UtA-PI 结合母体特征可预测 45%的早产 PE，假阳性率为 10%。
早孕期 UtA-PI 随孕周从 11 周到 13 周逐渐降低，与早产风险相关，但与足月 PE 无关。
