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First trimester screening for pre‐eclampsia in Chinese pregnancies: case–control study
Author(s) -
Cheng YKY,
Leung TY,
Law LW,
Ting YH,
Law KM,
Sahota DS
Publication year - 2018
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.14970
Subject(s) - eclampsia , obstetrics , first trimester , medicine , pregnancy , second trimester , gestation , biology , genetics
Objective To assess the potential of screening for pre‐eclampsia (PE) in a Chinese population. Design Case–control study. Setting Teaching hospital in Hong Kong. Population A total of 3330 women having a viable singleton pregnancy attending first‐trimester Down‐syndrome screening. Methods Mean arterial pressure (MAP), bilateral uterine artery pulsatility index (UtA‐PI), and placental growth factor (PlGF) were measured. Screening markers were transformed to multiples of the gestational median (MoM) and adjusted for maternal and pregnancy characteristics. MoM distributions in PE and non‐PE pregnancies were compared with published expected values. PE screening performance was assessed using area under receiver operating curves (AUROC). Main outcome measures PE detection rate. Results A total of 30 (0.9%) women developed either early (<34 weeks) or late (≥34 weeks) onset PE. MAP was dependent on maternal BMI, UtA‐PI on fetal crown rump length, uterine artery peak systolic velocity (UtA‐PSV) on maternal age and gestation, and PlGF on gestation in non‐PE pregnancies. MoM distributions determined using published Fetal Medicine Foundation models deviated significantly from one for both MAP ( P < 0.0001) and PI ( P < 0.0001), but not PlGF ( P = 0.52) in non‐PE pregnancies, whilst PlGF MoM distributions in those who developed early as opposed to late onset PE were significantly higher ( P = < 0.05). AUROC for any PE using multiple markers was 0.72 (95% CI: 0.64–0.81) with detection rates of 72 and 55% for early and late PE, respectively, for a 10% false positive rate. Conclusion Detection rates for PE in our Chinese population were lower than the expected 90–95% even after adjusting MoM for local women's characteristics. Funding General Research Fund (Project number 470513). Tweetable abstract Pre‐eclampsia screening in the Chinese population had detection rates lower than previously published results.