Rolle Valeria, Chaveeva Petya, Diaz-Navarro Ander, Fernández-Buhigas Irene, Cuenca-Gómez Diana, Tilkova Tanya, Santacruz Belén, Pérez Teresa, Gil Maria M
Faculty of Statistical Studies, Complutense University of Madrid, 28040 Madrid, Spain.
Dr. Shterev Hospital, 1330 Sofia, Bulgaria.
Medicina (Kaunas). 2024 Nov 21;60(12):1909. doi: 10.3390/medicina60121909.
: To evaluate the diagnostic accuracy of widely available biomarkers longitudinally measured throughout pregnancy to predict all and term (delivery at ≥37 weeks) preeclampsia (PE). : This is a longitudinal retrospective study performed at Hospital Universitario de Torrejón (Madrid, Spain) and Shterev Hospital (Sofia, Bulgaria) between August 2017 and December 2022. All pregnant women with singleton pregnancies and non-malformed live fetuses attending their routine ultrasound examination and first-trimester screening for preterm PE at 11 + 0 to 13 + 6 weeks' gestation at the participating centers were invited to participate in a larger study for the prediction of pregnancy complications. The dataset was divided into two subsets to develop and validate a joint model of time-to-event outcome and longitudinal data, and to evaluate how the area under the receiving operating characteristic curve (AUROC) evolved with time. : 4056 pregnancies were included in the training set (59 all PE, 40 term PE) and 944 in the validation set (23 all PE, 20 term PE). For the joint model and all PE, the AUROC was 0.84 (95% CI 0.73 to 0.94) and the detection rate (DR) for a 10% screening positive rate (SPR) was 56.5 (95% CI 34.5 to 76.8). For term PE, AUROC was 0.80 (95% CI 0.69 to 0.91), and DR for a 10% SPR was 55.0 (95% CI 31.5 to 76.9). The AUROC using only information from the first trimester was 0.50 (95% CI 0.37 to 0.64) and it increased to 0.84 (0.73 to 0.94) when using all information available. : Routinely measuring MAP and UtA-PI throughout pregnancy may improve the predictive prediction power for all and term-PE.
评估孕期纵向测量的广泛可用生物标志物对预测所有子痫前期（PE）和足月（≥37周分娩）子痫前期的诊断准确性。：这是一项纵向回顾性研究，于2017年8月至2022年12月在西班牙马德里的托雷洪大学医院和保加利亚索菲亚的什捷列夫医院进行。所有单胎妊娠且胎儿无畸形的孕妇，在参与中心于妊娠11 + 0至13 + 6周进行常规超声检查和早产PE的孕早期筛查时，被邀请参加一项更大的妊娠并发症预测研究。数据集被分为两个子集，以开发和验证事件发生时间结局与纵向数据的联合模型，并评估接受者操作特征曲线下面积（AUROC）如何随时间演变。：训练集纳入4056例妊娠（59例所有PE，40例足月PE），验证集纳入944例（23例所有PE，20例足月PE）。对于联合模型和所有PE，AUROC为0.84（95%CI 0.73至0.94），10%筛查阳性率（SPR）时的检测率（DR）为56.5（95%CI 34.5至76.8）。对于足月PE，AUROC为0.80（95%CI 0.69至0.91），10%SPR时的DR为55.0（95%CI 31.5至76.9）。仅使用孕早期信息时AUROC为0.50（95%CI 0.37至0.64），使用所有可用信息时增至0.84（0.73至0.94）。：孕期常规测量平均动脉压（MAP）和子宫动脉搏动指数（UtA-PI）可能会提高对所有子痫前期和足月子痫前期的预测能力。
