title: Prediction of small-for-gestation neonates from biophysical and biochemical markers at 11-13 weeks.
abstract: OBJECTIVE
  To develop a model for prediction of small-for-gestational age (SGA) neonates in the absence of preeclampsia (PE) based on maternal factors and biophysical and biochemical markers at 11-13 weeks' gestation.
  
  
  METHODS
  Screening study in 1,536 SGA and 31,314 non-SGA pregnancies based on maternal characteristics, fetal nuchal translucency (NT) thickness, serum pregnancy-associated plasma protein-A (PAPP-A) and free β-human chorionic gonadotrophin (β-hCG). We also measured mean arterial pressure (MAP), uterine artery pulsatility index (PI) and performed case-control studies for measurement of maternal serum concentration of placental growth factor (PLGF), placental protein 13 (PP13) and A Disintegrin And Metalloprotease (ADAM12). Regression analysis was used to develop a model for the prediction of SGA.
  
  
  RESULTS
  In the SGA group, uterine artery PI and MAP were increased and serum PAPP-A, free β-hCG, PLGF, PP13, and ADAM12 and fetal NT were decreased. At a false positive rate of 10%, the estimated detection rate by a combination of maternal factors and biophysical and biochemical markers at 11-13 weeks was 73% for SGA requiring delivery before 37 weeks and 46% for those delivering at term.
  
  
  CONCLUSIONS
  Half of pregnancies with SGA neonates in the absence of PE could potentially be identified at 11-13 weeks.
authors.affiliation: Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, Denmark Hill, London, UK.
authors.forename: George
authors.initials: G
authors.lastname: Karagiannis
authors.forename: Ranjit
authors.initials: R
authors.lastname: Akolekar
authors.forename: Rita
authors.initials: R
authors.lastname: Sarquis
authors.forename: David
authors.initials: D
authors.lastname: Wright
authors.forename: Kypros H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D000465:Algorithms; D015415:Biomarkers / Q000097:blood*; D001794:Blood Pressure; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000097:blood*; D048208:Nuchal Translucency Measurement; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D011673:Pulsatile Flow; D018570:Risk Assessment / Q000379:methods; D055988:Uterine Artery / Q000000981:diagnostic imaging* / Q000502:physiology
chemical_list: D015415:Biomarkers