An integrated model for the prediction of preeclampsia using maternal factors and uterine artery Doppler velocimetry in unselected low-risk women.
OBJECTIVE
The purpose of this study was to develop a predictive model for preeclampsia.


METHODS
This was a prospective screening study for preeclampsia using uterine artery Doppler ultrasound in unselected low-risk singleton pregnancies at community hospitals in the UK (n = 32,157). Logistic regression models were developed and their predictive ability assessed using the area under the receiver operator curve (AROC).


RESULTS
Six hundred twelve (2.0%) women developed preeclampsia, and 144 (0.5%) required early delivery (<34 weeks). A model using both maternal and ultrasound factors had an AROC of 0.798, which was higher than ultrasound alone (0.729, P < .0001) or maternal factors alone (0.712, P < .0001). In early onset disease, the ROC of ultrasound alone (0.922) was not significantly improved by adding maternal predictors (0.945, P = .27). In contrast, late onset disease was better predicted by the combined model (AROC 0.798) than ultrasound alone (AROC 0.729, P < .0001) or maternal factors alone (AROC 0.712, P < .0001).


CONCLUSIONS
The combination of uterine artery Doppler ultrasound and maternal factors provided the best estimate of risk.
Yu
Christina K H
CK
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital Medical School, Denmark Hill, London, UK. chrissieyu@aol.com
Smith
Gordon C S
GC
Papageorghiou
Aris T
AT
Cacho
Ana Maria
AM
Nicolaides
Kypros H
KH
D000328:Adult; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D016015:Logistic Models; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D011247:Pregnancy; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler; D014599:Uterus / Q000098:blood supply*; D014621:Vagina / Q000098:blood supply