title: Performance of a first-trimester screening of preeclampsia in a routine care low-risk setting.
abstract: OBJECTIVE
  We sought to evaluate the effectiveness of an integrated first-trimester screening test to predict preeclampsia (PE).
  
  
  METHODS
  A prospective cohort of singleton pregnancies underwent routine first-trimester screening from 2009 through 2011 (n = 5759). A logistic regression-based predictive model for early- and late-onset PE was constructed based on: maternal characteristics; levels of pregnancy-associated plasma protein-A and free β-human chorionic gonadotropin at 8-12 weeks; and blood pressure and uterine artery Doppler at 11.0-13.6 weeks.
  
  
  RESULTS
  Of the 5170 enrolled participants, 136 (2.6%) developed PE (early PE: 26 [0.5%]; late PE: 110 [2.1%]). At 5% and 10% false-positive rates, detection rates were 69.2% and 80.8% for early PE (area under the curve, 0.95; 95% confidence interval, 0.94-0.98) and 29.4% and 39.6% for late PE (area under the curve, 0.71; 95% confidence interval, 0.66-0.76), respectively.
  
  
  CONCLUSIONS
  First-trimester screening combining maternal factors with uterine artery Doppler, blood pressure, and pregnancy-associated plasma protein-A is useful to predict PE in a routine care setting.
authors.affiliation: Department of Maternal-Fetal Medicine, Institute Clinic of Gynecology, Obstetrics, and Neonatology, Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Scazzocchio
authors.forename: Francesc
authors.initials: F
authors.lastname: Figueras
authors.forename: Fatima
authors.initials: F
authors.lastname: Crispi
authors.forename: Eva
authors.initials: E
authors.lastname: Meler
authors.forename: Narcís
authors.initials: N
authors.lastname: Masoller
authors.forename: Raquel
authors.initials: R
authors.lastname: Mula
authors.forename: Eduard
authors.initials: E
authors.lastname: Gratacos
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D055988:Uterine Artery / Q000000981:diagnostic imaging*
chemical_list: D011266:Pregnancy-Associated Plasma Protein-A