Department of Obstetrics and Gynecology, Harapan Kita National Women and Children Hospital, Letjen S. Parman Street, Number Kav 87, Palmerah, West Jakarta, 11420, Jakarta, Indonesia.
Indonesian Prenatal Institute, Jakarta, Indonesia.
J Ultrasound. 2023 Mar;26(1):155-162. doi: 10.1007/s40477-022-00697-w. Epub 2022 Aug 2.
To develop a Bayesian survival-time model for the prediction of pre-eclampsia (PE) at the first trimester using a combination of established biomarkers including maternal characteristics and history, mean arterial pressure (MAP), uterine artery Doppler pulsatility index (UtA-PI), and Placental Growth Factor (PlGF)) with an ophthalmic artery Doppler peak ratio (PR) analysis.
The receiving operator curve (ROC) analysis was used to determine the area under the curve (AUC), detection rate (DR), and positive screening cut-off value of the model in predicting the occurrence of early-onset PE (< 34 weeks' gestation) and preterm PE (< 37 weeks' gestation).
Of the 946 eligible participants, 71 (7.49%) subjects were affected by PE. The incidences of early-onset and preterm PE were 1% and 2.2%, respectively. At a 10% false-positive rate, using the high-risk cut-off 1:49, with AUC 0.981 and 95%CI 0.965-0.998, this model had an 100% of DR in predicting early-onset PE. The DR of this model in predicting preterm PE is 71% when using 1:13 as the cut-off, with AUC 0.919 and 95%CI 0.875-0.963.
Combination ophthalmic artery Doppler PR with the previously established biomarkers could improve the accuracy of early and preterm PE prediction at the first trimester screening.
利用已建立的生物标志物（包括母体特征和病史、平均动脉压（MAP）、子宫动脉多普勒搏动指数（UtA-PI）和胎盘生长因子（PlGF））结合眼动脉多普勒峰值比（PR）分析，建立预测早发型子痫前期（PE）的贝叶斯生存时间模型。
采用受试者工作特征曲线（ROC）分析确定模型预测早发型 PE（<34 周妊娠）和早产 PE（<37 周妊娠）的曲线下面积（AUC）、检出率（DR）和阳性筛查截断值。
在 946 名合格的参与者中，有 71 名（7.49%）受试者患有 PE。早发型和早产 PE 的发生率分别为 1%和 2.2%。在假阳性率为 10%的情况下，使用高危截断值 1:49，AUC 为 0.981，95%CI 为 0.965-0.998，该模型预测早发型 PE 的 DR 为 100%。当使用 1:13 作为截断值时，该模型预测早产 PE 的 DR 为 71%，AUC 为 0.919，95%CI 为 0.875-0.963。
将眼动脉多普勒 PR 与先前建立的生物标志物相结合，可以提高早孕期筛查预测早发型和早产型 PE 的准确性。
