title: Validation of a first-trimester screening model for pre-eclampsia in an unselected population.
abstract: OBJECTIVE
  To validate the performance of a previously constructed first-trimester predictive model for pre-eclampsia (PE) in routine care of an unselected population.
  
  
  METHODS
  A validation cohort of 4621 consecutive women attending their routine first-trimester ultrasound examination was used to test a prediction model for PE that had been developed previously in 5170 women. The prediction model included maternal factors, uterine artery Doppler, blood pressure and pregnancy-associated plasma protein-A. Model performance was evaluated using receiver-operating characteristics (ROC) curve analysis and ROC curves from both cohorts were compared unpaired.
  
  
  RESULTS
  Among the 4203 women included in the final analysis, 169 (4.0%) developed PE, including 141 (3.4%) cases of late-onset PE and 28 (0.7%) cases of early-onset PE. For early-onset PE, the model showed an area under the ROC curve of 0.94 (95% CI, 0.88-0.99), which did not differ significantly (P = 0.37) from that obtained in the construction cohort (0.88 (95% CI, 0.78-0.99)). For late-onset PE, the final model showed an area under the ROC curve of 0.72 (95% CI, 0.66-0.77), which did not differ significantly (P = 0.49) from that obtained in the construction cohort (0.75 (95% CI, 0.67-0.82)).
  
  
  CONCLUSIONS
  The prediction model for PE achieved a similar performance to that obtained in the construction cohort when tested on a subsequent cohort of women, confirming its validity as a predictive model for PE. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
authors.affiliation: BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.|Obstetrics, Gynecology and Reproductive Medicine Department, Quirón Dexeus Universitari Hospital, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Scazzocchio
authors.affiliation: BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Crovetto
authors.affiliation: BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Triunfo
authors.affiliation: BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Gratacós
authors.affiliation: BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Figueras
mesh_terms: D000328:Adult; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D011446:Prospective Studies; D012372:ROC Curve; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D055988:Uterine Artery / Q000000981:diagnostic imaging*
chemical_list: D011266:Pregnancy-Associated Plasma Protein-A
keywords: first-trimester screening; pre-eclampsia; predictive model validation