title: Combined screening for preeclampsia and small for gestational age at 11-13 weeks.
abstract: OBJECTIVE
  To combine a specific algorithm for small for gestational age (SGA) without preeclampsia (PE) and another algorithm for PE in the prediction of SGA and PE.
  
  
  METHODS
  This was a screening study of singleton pregnancies at 11-13 weeks including 1,426 (2.3%) that subsequently developed PE, 3,168 (5.1%) that delivered SGA neonates and 57,458 that were unaffected by PE and SGA. We developed a prediction algorithm for SGA requiring delivery before 37 weeks' gestation (preterm-SGA) from maternal characteristics, uterine artery pulsatility index, mean arterial pressure, serum pregnancy-associated plasma protein-A and placental growth factor multiple of the median values. We then examined the performance of this algorithm individually and in combination with a previously reported algorithm for early-PE in the prediction of SGA and PE.
  
  
  RESULTS
  When screen positivity was defined by risk cutoff of 1:200 using the algorithm for early-PE and the risk cutoff of 1:150 using the algorithm for preterm-SGA, the false positive rate was 10.9% and the detection rates of early-PE, late-PE, preterm-SGA and term-SGA were 95.3, 45.6, 55.5 and 44.3%, respectively.
  
  
  CONCLUSIONS
  Effective first-trimester screening for early-PE and preterm-SGA can be provided by the combined use of the specific algorithms.
authors.affiliation: Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
authors.forename: Leona C Y
authors.initials: LC
authors.lastname: Poon
authors.forename: Argyro
authors.initials: A
authors.lastname: Syngelaki
authors.forename: Ranjit
authors.initials: R
authors.lastname: Akolekar
authors.forename: Jonathan
authors.initials: J
authors.lastname: Lai
authors.forename: Kypros H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D000328:Adult; D000465:Algorithms; D001794:Blood Pressure; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D008403:Mass Screening / Q000379:methods*; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000097:blood / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood*; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D047928:Premature Birth / Q000453:epidemiology; D011673:Pulsatile Flow; D012372:ROC Curve; D014463:Ultrasonography; D006113:United Kingdom / Q000453:epidemiology; D055988:Uterine Artery / Q000000981:diagnostic imaging
chemical_list: C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor; D011266:Pregnancy-Associated Plasma Protein-A; C579283:PAPPA protein, human