Goto Minako, Koide Keiko, Tokunaka Mayumi, Takita Hiroko, Hamada Shoko, Nakamura Masamistu, Matsuoka Ryu, Sekizawa Akihiko, Poon Liona C
Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan.
Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China.
Hypertens Res. 2021 Jun;44(6):685-691. doi: 10.1038/s41440-020-00571-4. Epub 2020 Nov 6.
This study aimed to investigate the diagnostic accuracy of the Fetal Medicine Foundation (FMF) Bayes theorem-based model for the prediction of preeclampsia (PE) at 11-13 weeks of gestation in the Japanese population. In this prospective cohort study, we invited 2655 Japanese women with singleton pregnancies at 11-13 weeks of gestation to participate, of whom 1036 women provided written consent. Finally, we included 913 women for whom all measurements and perinatal outcomes were available. Data on maternal characteristics and medical history were recorded. Mean arterial pressure (MAP), uterine artery pulsatility index, and maternal serum placental growth factor (PlGF) were measured. The patients delivered their babies at Showa University Hospital between June 2017 and December 2019. Participants were classified into high- and low-risk groups according to the FMF Bayes theorem-based model. Frequencies of PE were compared between groups. The screening performance of the model was validated using the area under receiver operating characteristic (AUROC) curve. A total of 26 patients (2.8%) developed PE, including 11 patients (1.2%) with preterm PE (delivery at <37 weeks). The frequency of preterm PE was significantly higher in the high-risk group than in the low-risk group (3.8% vs. 0.2%, p < 0.05). This population model achieved a 91% detection rate for the prediction of preterm PE at a screen-positive rate of 10% by a combination of maternal characteristics, MAP, and PlGF. The AUROC curve for the prediction of preterm PE was 0.962 (0.927-0.981). In conclusion, the prediction of preterm PE using the FMF Bayes theorem-based model is feasible in the Japanese population.
本研究旨在调查胎儿医学基金会（FMF）基于贝叶斯定理的模型在预测日本人群妊娠11至13周子痫前期（PE）方面的诊断准确性。在这项前瞻性队列研究中，我们邀请了2655名妊娠11至13周的日本单胎妊娠女性参与，其中1036名女性提供了书面同意。最终，我们纳入了913名所有测量值和围产期结局均可用的女性。记录了产妇特征和病史数据。测量了平均动脉压（MAP）、子宫动脉搏动指数和母体血清胎盘生长因子（PlGF）。患者于2017年6月至2019年12月在昭和大学医院分娩。根据基于FMF贝叶斯定理的模型将参与者分为高风险组和低风险组。比较了两组之间PE的发生率。使用受试者操作特征（AUROC）曲线下面积验证了该模型的筛查性能。共有26例患者（2.8%）发生了PE，其中包括早产PE患者11例（1.2%，孕周<37周分娩）。高风险组早产PE的发生率显著高于低风险组（3.8%对0.2%，p<0.05）。该人群模型通过结合产妇特征、MAP和PlGF，在筛查阳性率为10%时，早产PE预测的检出率达到91%。早产PE预测的AUROC曲线为0.962（0.927 - 0.981）。总之，在日本人群中，使用基于FMF贝叶斯定理的模型预测早产PE是可行的。
