title: Prediction of spontaneous preterm delivery from maternal factors, obstetric history and placental perfusion and function at 11-13 weeks.
abstract: OBJECTIVE
  To develop a model for prediction of spontaneous delivery before 34 weeks based on maternal factors, placental perfusion and function at 11-13 weeks' gestation.
  
  
  METHODS
  Two groups of studies: first, screening study of maternal characteristics, serum pregnancy-associated plasma protein-A (PAPP-A), free β-human chorionic gonadotrophin (β-hCG) and uterine artery pulsatility index (PI). Second, case-control studies of maternal serum or plasma concentration of placental growth factor (PlGF), placental protein 13 (PP13), a disintegrin and metalloprotease 12 (ADAM12), inhibin-A and activin-A. Regression analysis was used to develop a model for the prediction of spontaneous early delivery.
  
  
  RESULTS
  Spontaneous early delivery occurred in 365 (1.1%) of the 34 025 pregnancies. A model based on maternal factors could detect 38.2% of the preterm deliveries in women with previous pregnancies at or beyond 16 weeks and 18.4% in those without, at a false positive rate (FPR) of 10%. In the preterm delivery group, compared with unaffected pregnancies there were no significant differences in the markers of placental perfusion or function, except for PAPP-A which was reduced.
  
  
  CONCLUSIONS
  Patient-specific risk of preterm delivery is provided by maternal factors and obstetric history. Placental perfusion and function at 11-13 weeks are not altered in pregnancies resulting in spontaneous early delivery.
authors.affiliation: Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
authors.forename: Jarek
authors.initials: J
authors.lastname: Beta
authors.forename: Ranjit
authors.initials: R
authors.lastname: Akolekar
authors.forename: Walter
authors.initials: W
authors.lastname: Ventura
authors.forename: Argyro
authors.initials: A
authors.lastname: Syngelaki
authors.forename: Kypros H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005260:Female; D005865:Gestational Age; D006801:Humans; D010920:Placenta / Q000098:blood supply / Q000503:physiopathology*; D011247:Pregnancy; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis; D047928:Premature Birth / Q000175:diagnosis*; D011296:Prenatal Diagnosis / Q000379:methods*; D011673:Pulsatile Flow; D014463:Ultrasonography; D055988:Uterine Artery / Q000737:chemistry / Q000000981:diagnostic imaging
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A