Department of Women's, Child and Adolescent Health, Assis Chateaubriand Maternity School, Federal University of Ceará (UFC), Fortaleza, Brazil.
University of Fortaleza (UNIFOR), Fortaleza, Brazil.
Minerva Obstet Gynecol. 2023 Dec;75(6):503-511. doi: 10.23736/S2724-606X.22.05061-8. Epub 2022 Jun 22.
To use the algorithm of the Fetal Medicine Foundation (FMF) to determine the cutoff point for prediction of preeclampsia (PE) in a Brazilian population.
Randomized clinical trial with 274 nulliparous patients at gestational age between 11 and 13 weeks and 6 days. To calculate the risk of PE, the algorithm available at the website of the FMF (http://fetalmedicine.org/research/assess/preeclampsia/first-trimester) was used. Among the patients, 138 did not use preventive measures (100 mg/day aspirin [ASA]). Youden's criteria were used to calculate the cutoff point. To test the effectiveness of 100 mg/day ASA in preventing PE, the patients were divided into two groups - at risk above and below the cutoff point.
In the group comprising the 135 patients that did not take ASA, the median age was 22 years, the Body Mass Index (BMI) was 59.3 kg/m, the mean arterial pressure (MAP) was 73.3 mmHg, and the mean pulsatility index of uterine artery Doppler was 1.71. The median gestational age at delivery was 39.3 (38.1-40.3) weeks. The prevalence of PE was 11.1%. In our sample, the use of 100 mg/day ASA reduced total PE by 36.3% (prevalence of PE in the group above the cutoff point was 19% and 12.1% when ASA and placebo were used, respectively).
The cutoff point defined for prediction of PE was 1:155 with sensitivity of 80%, specificity of 57.5%, positive predictive value of 19.1%, and negative predictive value of 95%, which should help to select patients that will benefit from prophylactic ASA.
使用胎儿医学基金会（FMF）的算法来确定预测巴西人群先兆子痫（PE）的截止值。
这是一项随机临床试验，纳入了 274 名孕龄在 11 至 13 周零 6 天的初产妇。为了计算 PE 的风险，使用了 FMF 网站上提供的算法（http://fetalmedicine.org/research/assess/preeclampsia/first-trimester）。在这些患者中，有 138 名患者未使用预防措施（每日 100mg 阿司匹林[ASA]）。使用约登指数计算截止值。为了检验每日 100mg ASA 预防 PE 的有效性，将患者分为两个组 - 截止值以上和以下的风险组。
在未服用 ASA 的 135 名患者中，中位数年龄为 22 岁，体重指数（BMI）为 59.3kg/m2，平均动脉压（MAP）为 73.3mmHg，子宫动脉多普勒搏动指数的平均值为 1.71。中位分娩孕周为 39.3（38.1-40.3）周。PE 的患病率为 11.1%。在我们的样本中，每日 100mg ASA 的使用将总 PE 降低了 36.3%（截止值以上组的 PE 患病率分别为 19%和 12.1%，当使用 ASA 和安慰剂时）。
预测 PE 的截止值定义为 1:155，其灵敏度为 80%，特异性为 57.5%，阳性预测值为 19.1%，阴性预测值为 95%，这有助于选择将从预防性 ASA 中获益的患者。
