title: Serum screening in first trimester to predict pre-eclampsia, small for gestational age and preterm delivery: systematic review and meta-analysis.
abstract: BACKGROUND
  Early assessment before the establishment of placental dysfunction has the potential to improve treatment and prognosis for clinical practice.The objective of the study is to investigate the accuracy of serum biochemical markers(Pregnancy- Associated Plasma Protein-A (PAPP-A), human Chorionic Gonadotropin (hCG), Placental Growth Factor (PlGF), Placental Protein 13 (PP13) used in first trimester serum screening in predicting preelampsia, small for gestational age (SGA) and preterm delivery.
  
  
  METHODS
  The data sources included Medline, Embase, Cochrane library, Medion, hand searching of relevant journals, reference list checking of included articles and contact with experts. Two reviewers independently selected the articles. Two authors independently extracted data on study characteristics, quality and results.
  
  
  RESULTS
  The results showed low predictive accuracy overall. For preeclampsia, the best predictor was PlGF; LR + 4.01 (3.74, 4.28), LR-(0.67, 0.64, 0.69). The predictive value of serum markers for early preeclampsia was better than that of late preeclampsia. For SGA the best predictor was PP13; LR+ 3.70 (3.39, 4.03), LR- 0.70 (0.67, 0.73). For preterm delivery, the best predictor was PP13; LR+ 4.16 (2.72, 5.61), LR- 0.56 (0.45, 0.67).
  
  
  CONCLUSIONS
  First trimester screening analytes have low predictive accuracy for pre-eclampsia, small for gestational age and preterm delivery. However, the predict value of first trimester analytes is not worse than that of the second trimester markers.
authors: The Second Xiangya Hospital, Central South University, No.139, Middle Renmin Road, Changsha, Hunan, 410011, P.R. China. azxyq731@163.com.
authors: Yan
authors: Y
authors: Zhong
authors: The Second Xiangya Hospital, Central South University, No.139, Middle Renmin Road, Changsha, Hunan, 410011, P.R. China. yanmie137@126.com.
authors: Fufan
authors: F
authors: Zhu
authors: The Second Xiangya Hospital, Central South University, No.139, Middle Renmin Road, Changsha, Hunan, 410011, P.R. China. dylcsu@sina.cn.
authors: Yiling
authors: Y
authors: Ding
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D037161:Galectins; D006801:Humans; D007236:Infant, Small for Gestational Age / Q000097:blood*; D008565:Membrane Proteins; D007752:Obstetric Labor, Premature / Q000097:blood* / Q000175:diagnosis; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis; D011237:Predictive Value of Tests; D011247:Pregnancy; D011257:Pregnancy Proteins; D011261:Pregnancy Trimester, First / Q000097:blood*
chemical_list: D015415:Biomarkers; D037161:Galectins; C038195:LGALS13 protein, human; D008565:Membrane Proteins; C098069:PIGF protein, human; D011257:Pregnancy Proteins