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First trimester maternal serum placental protein 13 for the prediction of pre‐eclampsia in women with a priori high risk
Author(s) -
Khalil Asma,
Cowans Nicholas J.,
Spencer Kevin,
Goichman Sergey,
Meiri Hamutal,
Harrington Kevin
Publication year - 2009
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.2287
Subject(s) - eclampsia , medicine , obstetrics , preeclampsia , gestation , pregnancy , receiver operating characteristic , gynecology , genetics , biology
Objective To evaluate whether first trimester maternal serum PP13 can predict pre‐eclampsia among women with a priori high risk. Method This was a nested case–control study. Women less than 14 weeks' gestation at increased risk of developing pre‐eclampsia were recruited. Venous blood samples were assayed for PP13 using enzyme‐linked immunosorbent assay. PP13 multiples of median (MoM) were calculated and adjusted for body mass index, ethnicity, smoking, maternal age and parity. For each case of pre‐eclampsia ( n = 42), five controls were randomly selected. PP13 levels were compared between women who developed pre‐eclampsia and controls using the Wilcoxon rank sum test. Sensitivity and false‐positive rates were derived from receiver operating characteristic curves. Results Women who developed pre‐eclampsia had significantly lower ( P < 0.001) PP13 MoMs compared with controls. PP13 MoMs for controls and pre‐eclampsia cases were 1.0 (range 0.0–10.0) and 0.4 (range 0.0–7.0), respectively ( P < 0.001). At a MoM cutoff of 0.53, for a false‐positive rate of 10%, sensitivity was 50% for pre‐eclampsia at term (>37 weeks), 62% for preterm pre‐eclampsia (<37 weeks) and 71% for early‐onset pre‐eclampsia (<34 weeks). Conclusion First trimester PP13 can predict pre‐eclampsia in women at increased a priori risk and predicts early‐onset better than late‐onset disease. Copyright © 2009 John Wiley & Sons, Ltd.