title: Prediction of preeclampsia by mean arterial pressure at 11-13 and 20-24 weeks' gestation.
abstract: OBJECTIVE
  To assess the performance of screening for preeclampsia (PE) by mean arterial pressure (MAP) at 11-13 and at 20-24 weeks' gestation.
  
  
  METHODS
  MAP was measured at 11-13 and 20-24 weeks in 17,383 singleton pregnancies, including 70 with early PE, requiring delivery <34 weeks' gestation, 143 with preterm PE, delivering <37 weeks and 537 with total PE. MAP was expressed as multiple of the median (MoM) after adjustment for maternal characteristics and corrected for adverse pregnancy outcomes. The performance of screening for PE by maternal characteristics and MAP MoM at 11-13 weeks (MAP-1), MAP MoM at 20-24 weeks (MAP-2) and their combination was evaluated.
  
  
  RESULTS
  In screening by maternal characteristics and MAP-1, at a false-positive rate (FPR) of 10%, the detection rates (DR) of early PE, preterm PE and total PE were 74.3, 62.9 and 49.3%, respectively; the DR at FPR of 5% were 52.9, 42.7 and 35.8%. In screening by MAP-1 and MAP-2 the DR at FPR of 10%, were 84.3, 65.7 and 52.5%; the DR at FPR of 5% were 60.0, 49.7 and 37.6%, respectively.
  
  
  CONCLUSIONS
  Performance of screening for PE by MAP is best when measurements are taken at both 11-13 and 20-24 weeks' gestation than at only one of these gestational ranges.
authors.affiliation: Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
authors.forename: Dahiana
authors.initials: D
authors.lastname: Gallo
authors.forename: Leona C
authors.initials: LC
authors.lastname: Poon
authors.forename: Mariana
authors.initials: M
authors.lastname: Fernandez
authors.forename: David
authors.initials: D
authors.lastname: Wright
authors.forename: Kypros H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D000328:Adult; D062186:Arterial Pressure / Q000502:physiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000502:physiology*; D011262:Pregnancy Trimester, Second / Q000502:physiology*; D011446:Prospective Studies