title: First trimester aneuploidy screening program for preeclampsia prediction in a portuguese obstetric population.
abstract: Objective. To evaluate the performance of a first trimester aneuploidy screening program for preeclampsia (PE) prediction in a Portuguese obstetric population, when performed under routine clinical conditions. Materials and Methods. Retrospective cohort study of 5672 pregnant women who underwent routine first trimester aneuploidy screening in a Portuguese university hospital from January 2009 to June 2013. Logistic regression-based predictive models were developed for prediction of PE based on maternal characteristics, crown-rump length (CRL), nuchal translucency thickness (NT), and maternal serum levels of pregnancy-associated plasma protein-A (PAPP-A) and free beta-subunit of human chorionic gonadotropin (free β -hCG). Results. At a false-positive rate of 5/10%, the detection rate for early-onset (EO-PE) and late-onset (LO-PE) PE was 31.4/45.7% and 29.5/35.2%, respectively. Although both forms of PE were associated with decreased PAPP-A, logistic regression analysis revealed significant contributions from maternal factors, free β -hCG, CRL, and NT, but not PAPP-A, for prediction of PE. Conclusion. Our findings support that both clinical forms of EO-PE and LO-PE can be predicted using a combination of maternal history and biomarkers assessed at first trimester aneuploidy screening. However, detection rates were modest, suggesting that models need to be improved with additional markers not included in the current aneuploidy screening programs.
authors.affiliation: Department of Pathology, Porto Hospital Center, 4099-001 Porto, Portugal ; Department of Health Information and Decision Sciences (CIDES), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal ; Institute for Molecular and Cell Biology (IBMC), University of Porto, 4150-180 Porto, Portugal.
authors.forename: Cláudia
authors.initials: C
authors.lastname: Teixeira
authors.affiliation: Institute for Molecular and Cell Biology (IBMC), University of Porto, 4150-180 Porto, Portugal.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Tejera
authors.affiliation: Department of Pathology, Porto Hospital Center, 4099-001 Porto, Portugal.
authors.forename: Helena
authors.initials: H
authors.lastname: Martins
authors.affiliation: Department of Women, Porto Hospital Center, 4099-001 Porto, Portugal.
authors.forename: António Tomé
authors.initials: AT
authors.lastname: Pereira
authors.affiliation: Department of Health Information and Decision Sciences (CIDES), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal ; Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal.
authors.forename: Altamiro
authors.initials: A
authors.lastname: Costa-Pereira
authors.affiliation: Institute for Molecular and Cell Biology (IBMC), University of Porto, 4150-180 Porto, Portugal ; Department of Biochemistry, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal.
authors.forename: Irene
authors.initials: I
authors.lastname: Rebelo