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Clinical evaluation of a first trimester algorithm predicting the risk of hypertensive disease of pregnancy
Author(s) -
Park Felicity J.,
Leung Constance H.Y.,
Poon Leona C.Y.,
Williams Paul F.,
Rothwell Samantha J.,
Hyett Jon A.
Publication year - 2013
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12126
Subject(s) - eclampsia , medicine , obstetrics , pregnancy , logistic regression , body mass index , population , gestational hypertension , uterine artery , preeclampsia , gestational age , gynecology , gestation , genetics , environmental health , biology
Background The aim of this study is to validate the F etal M edicine F oundation ( FMF ) multiple logistic regression algorithm for prediction of risk of pre‐eclampsia in an A ustralian population. This model, which predicts risk using the population rate of pre‐eclampsia, a variety of demographic factors, mean maternal arterial blood pressure ( MAP ), uterine artery PI ( U tA PI) and pregnancy‐associated plasma protein A ( PAPP ‐ A ), has been shown to predict early‐onset pre‐eclampsia (delivery prior to 34 weeks) in 95% of women at a 10% false‐positive rate. Methods All women who attended first trimester screening at the R oyal P rince A lfred H ospital had their body mass index ( BMI ), MAP and U tA PI assessed in addition to factors traditionally used to assess aneuploidy (including PAPP ‐ A M oM). After delivery, risks of early‐onset (delivery prior to 34 weeks) pre‐eclampsia, late pre‐eclampsia and gestational hypertension were calculated using the FMF risk algorithm. Results A total of 3099 women were screened and delivered locally. 3066 (98.9%) women had all data to perform pre‐eclampsia screening available. This included 3014 (98.3%) women with a live birth, where risks of early pre‐eclampsia were calculated. Twelve women were delivered before 34 weeks because of early pre‐eclampsia with a prevalence of early pre‐eclampsia of 1 in 256 pregnancies. Risks generated through the use of maternal history, MAP , U tA PI and PAPP ‐ A detected 41.7 and 91.7% of early pre‐eclampsia at a false‐positive rate of 5 and 10%, respectively. Conclusions This study shows that the FMF early pre‐eclampsia algorithm is effective in an Australian population.