title: Maternal characteristics, mean arterial pressure and serum markers in early prediction of preeclampsia.
abstract: OBJECTIVE
  In a previous study, we have described the predictive value of first-trimester Pregnancy-Associated Plasma Protein-A (PAPP-A), free β-subunit of human Chorionic Gonadotropin (fβ-hCG), Placental Growth Factor (PlGF) and A Disintegrin And Metalloprotease 12 (ADAM12) for early onset preeclampsia (EO-PE; delivery <34 weeks). The objective of the current study was to obtain the predictive value of these serum makers combined with maternal characteristics and first-trimester maternal mean arterial blood pressure (MAP) in a large series of patients, for both EO-PE and late onset PE (LO-PE; delivery ≥ 34 weeks).
  
  
  METHODS
  This was a nested case-control study, using stored first-trimester maternal serum from women who developed EO-PE (n = 68) or LO-PE (n = 99), and 500 uncomplicated singleton pregnancies. Maternal characteristics, MAP, and pregnancy outcome were collected for each individual woman and used to calculate prior risks for PE in a multiple logistic regression model. Models containing prior PE risks, serum markers, and MAP were developed for the prediction of EO-PE and LO-PE. The model-predicted detection rates (DR) for fixed 10% false-positive rates were calculated for EO-PE and LO-PE with or without the presence of a small-for-gestational age infant (SGA, birth weight <10(th) centile).
  
  
  RESULTS
  The best prediction model included maternal characteristics, MAP, PAPP-A, ADAM12, and PlGF, with DR of 72% for EO-PE and 49% for LO-PE. Prediction for PE with concomitant SGA was better than for PE alone (92% for EO-PE and 57% for LO-PE).
  
  
  CONCLUSIONS
  First-trimester MAP, PAPP-A, ADAM12, and PlGF combined with maternal characteristics and MAP are promising markers in the risk assessment of PE, especially for EO-PE complicated by SGA.
authors.affiliation: Department of Obstetrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands. S.Kuc@umcutrecht.nl
authors.forename: Sylwia
authors.initials: S
authors.lastname: Kuc
authors.forename: Maria P H
authors.initials: MP
authors.lastname: Koster
authors.forename: Arie
authors.initials: A
authors.lastname: Franx
authors.forename: Peter C J I
authors.initials: PC
authors.lastname: Schielen
authors.forename: Gerard H A
authors.initials: GH
authors.lastname: Visser
mesh_terms: D051722:ADAM Proteins / Q000097:blood; D000072199:ADAM12 Protein; D000328:Adult; D062186:Arterial Pressure / Q000502:physiology*; D015415:Biomarkers / Q000097:blood* / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008565:Membrane Proteins / Q000097:blood; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis* / Q000378:metabolism; D011237:Predictive Value of Tests; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood; D011261:Pregnancy Trimester, First / Q000097:blood / Q000502:physiology; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism
chemical_list: D015415:Biomarkers; D008565:Membrane Proteins; C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor; D051722:ADAM Proteins; D000072199:ADAM12 Protein; C000606480:ADAM12 protein, human; D011266:Pregnancy-Associated Plasma Protein-A; C579283:PAPPA protein, human