title: Competing risks model in screening for preeclampsia by biophysical and biochemical markers at 30-33 weeks' gestation.
abstract: OBJECTIVE
  To assess the risk for preeclampsia (PE) by maternal characteristics, uterine artery pulsatility index (Ut-PI), mean arterial pressure (MAP), serum placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) at 30-33 weeks' gestation.
  
  
  METHODS
  This was a screening study in singleton pregnancies including 2,140 that developed PE and 83,615 that were unaffected by PE. We developed a survival time model for the time of delivery for PE by combining maternal characteristics and history with Ut-PI, MAP, PlGF and sFlt-1 multiple of the median (MoM) values (combined test). Data on third-trimester MAP and Ut-PI were available in 350 cases of PE, and 13,878 unaffected pregnancies and data on PlGF and sFlt-1 were available in 118 cases of PE and 3,734 unaffected pregnancies. Modelled detection rate of all PE and PE requiring delivery within 4 and 6 weeks of the visit was estimated.
  
  
  RESULTS
  Screening by the combined test would detect 66, 98 and 86% of all PE and PE requiring delivery within 4 and 6 weeks of the visit, respectively, at a false positive rate of 5%.
  
  
  CONCLUSIONS
  Screening by biophysical and biochemical testing at 30-33 weeks could identify most pregnancies developing PE and requiring delivery within the subsequent 4 weeks.
authors.affiliation: Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, UK.
authors.forename: Santiago
authors.initials: S
authors.lastname: Garcia-Tizon Larroca
authors.forename: Ahmet
authors.initials: A
authors.lastname: Tayyar
authors.forename: Leona C
authors.initials: LC
authors.lastname: Poon
authors.forename: David
authors.initials: D
authors.lastname: Wright
authors.forename: Kypros H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D005865:Gestational Age; D006801:Humans; D016014:Linear Models; D008954:Models, Biological; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis*; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood; D011263:Pregnancy Trimester, Third / Q000097:blood*; D011296:Prenatal Diagnosis / Q000379:methods*; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers; C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor