title: First-trimester placental protein 13, PAPP-A, uterine artery Doppler and maternal characteristics in the prediction of pre-eclampsia.
abstract: OBJECTIVE
  To test the hypothesis that a combination of PP13, PAPP-A and first-trimester uterine artery Doppler would improve the prediction of pre-eclampsia.
  
  
  METHODS
  This is a prospective cohort study of pregnant women followed from the first-trimester to delivery. PP13 and PAPP-A were determined by immunoassay of maternal serum at 11-14 weeks', when uterine artery Doppler measurements were assessed. Cases identified with any form of pre-eclampsia were compared with a control group without pre-eclampsia. The sensitivity of each marker or their combinations in predicting pre-eclampsia for different fixed false positive rates was calculated from the ROC curves.
  
  
  RESULTS
  Forty two women were diagnosed with pre-eclampsia and 410 women with pregnancies not complicated by pre-eclampsia were used as controls. For a fixed false positive rate (FPR) of 20%, PP13, PAPP-A and mean uterine artery pulsatility index identified 49%, 58% and 62% respectively, of women who developed any form of pre-eclampsia. PP13 was best in predicting early onset pre-eclampsia with a sensitivity of 79% at a 20% FPR. Combinations of the three first-trimester assessments did not improve the prediction of pre-eclampsia in later pregnancy.
  
  
  CONCLUSIONS
  First-trimester PP13, PAPP-A and uterine artery PI are reasonable, individual predictors of women at risk to develop pre-eclampsia. Combinations of these assessments do not further improve the prediction of pre-eclampsia.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Ultrasound, Washington University in St. Louis, St. Louis, MO 63110, USA. odiboa@wudosis.wustl.edu
authors.forename: A O
authors.initials: AO
authors.lastname: Odibo
authors.forename: Y
authors.initials: Y
authors.lastname: Zhong
authors.forename: K R
authors.initials: KR
authors.lastname: Goetzinger
authors.forename: L
authors.initials: L
authors.lastname: Odibo
authors.forename: J L
authors.initials: JL
authors.lastname: Bick
authors.forename: C R
authors.initials: CR
authors.lastname: Bower
authors.forename: D M
authors.initials: DM
authors.lastname: Nelson
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D037161:Galectins / Q000032:analysis*; D006801:Humans; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000032:analysis*; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler; D055988:Uterine Artery / Q000000981:diagnostic imaging* / Q000502:physiology
chemical_list: D015415:Biomarkers; D037161:Galectins; C038195:LGALS13 protein, human; D011257:Pregnancy Proteins; D011266:Pregnancy-Associated Plasma Protein-A