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First‐trimester prediction of preterm birth using ADAM12, PAPP‐A, uterine artery Doppler, and maternal characteristics
Author(s) -
Goetzinger Katherine R.,
Cahill Alison G.,
Kemna Janet,
Odibo Linda,
Macones George A.,
Odibo Anthony O.
Publication year - 2012
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.3949
Subject(s) - medicine , uterine artery , gestation , obstetrics , pregnancy , receiver operating characteristic , prospective cohort study , pregnancy associated plasma protein a , gynecology , logistic regression , first trimester , biology , genetics
Objective The objective of this study was to estimate the efficiency of first‐trimester a disintegrin and metalloprotease 12 (ADAM12), pregnancy‐associated plasma protein A (PAPP‐A), uterine artery Doppler, and maternal characteristics in the prediction of preterm birth (PTB). Methods This was a prospective cohort study of patients presenting for first‐trimester aneuploidy screening. Maternal serum ADAM12 and PAPP‐A levels were measured by immunoassay, and mean uterine artery Doppler pulsatility indices were calculated. The primary outcome was PTB <34 weeks' gestation, and the secondary outcome was PTB <37 weeks' gestation. Logistic regression was used to model the prediction of PTB using ADAM12, PAPP‐A, uterine artery Doppler, and maternal characteristics, individually and in combination. Sensitivity, specificity, and area under the receiver‐operating characteristic curves were compared between models. Results Of 578 patients, 36 (6.2%) delivered <34 weeks, and 78 (13.5%) delivered <37 weeks. For a 20% fixed false positive rate, ADAM12, PAPP‐A, and uterine artery Doppler identified 58%, 52%, and 62% of patients with PTB <34 weeks and 42%, 48%, and 50% of patients with PTB <37 weeks, respectively. Combining these first‐trimester parameters did not improve the predictive efficiency of the models. Conclusion First‐trimester ADAM12, PAPP‐A, and uterine artery Doppler are each modestly predictive of PTB; however, combinations of these parameters do not further improve their screening efficiency. © 2012 John Wiley & Sons, Ltd.