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. 2013 Sep;32(9):1593-600.
doi: 10.7863/ultra.32.9.1593.

Efficiency of first-trimester uterine artery Doppler, a-disintegrin and metalloprotease 12, pregnancy-associated plasma protein a, and maternal characteristics in the prediction of preeclampsia

Katherine R Goetzinger  1 , Yan Zhong, Alison G Cahill, Linda Odibo, George A Macones, Anthony O Odibo
Affiliations

Efficiency of first-trimester uterine artery Doppler, a-disintegrin and metalloprotease 12, pregnancy-associated plasma protein a, and maternal characteristics in the prediction of preeclampsia

Katherine R Goetzinger et al. J Ultrasound Med. 2013 Sep.

Abstract

Objectives: The purpose of this study was to estimate the efficiency of first-trimester uterine artery Doppler, A-disintegrin and metalloprotease 12 (ADAM12), pregnancy-associated plasma protein A (PAPP-A), and maternal characteristics in the prediction of preeclampsia.

Methods: We conducted a prospective cohort study of patients presenting for first-trimester aneuploidy screening between 11 and 14 weeks' gestation. Maternal serum ADAM12 and PAPP-A levels were measured by an immunoassay, and mean uterine artery Doppler pulsatility indices were calculated. Outcomes of interest included preeclampsia, early preeclampsia (defined as requiring delivery at <34 weeks' gestation), and gestational hypertension. Logistic regression analysis was used to model the prediction of preeclampsia using ADAM12 multiples of the median (MoM), PAPP-A MoM, and uterine artery Doppler pulsatility index MoM, either individually or in combination. The sensitivity, specificity, and area under the receiver operating characteristic curves were used to compare the screening efficiency of the models using nonparametric U statistics.

Results: Among 578 patients with complete outcome data, there were 54 cases of preeclampsia (9.3%) and 13 cases of early preeclampsia (2.2%). Median ADAM12 levels were significantly lower in patients who developed preeclampsia compared to those who did not (0.81 versus 1.01 MoM; P = .04). For a fixed false-positive rate of 10%, ADAM12, PAPP-A, and uterine artery Doppler parameters in combination with maternal characteristics identified 50%, 48%, and 52% of patients who developed preeclampsia, respectively. Combining these first-trimester parameters did not improve the predictive efficiency of the models.

Conclusions: First-trimester ADAM12, PAPP-A, and uterine artery Doppler characteristics are not sufficiently predictive of preeclampsia. Combinations of these parameters do not further improve their screening efficiency.

Keywords: A-disintegrin and metalloprotease 12; placental dysfunction; preeclampsia; pregnancy-associated plasma protein A; uterine artery Doppler sonography.

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References

    1. American College of Obstetricians and Gynecologists . ACOG Practice Bulletin #33. American College of Obstetricians and Gynecologists; Washington DC: 2002. Diagnosis of management of preeclampsia and eclampsia.
    1. Confidential Enquiry into Maternal and Child Health (CEMACH) England, Wales and Northern Ireland. CEMACH; London: 2008. Perinatal Mortality.
    1. Dugoff L, Hobbins JC, Malone FD, et al. First-trimester maternal serum PAPP-A and free beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: A population based screening study (The FASTER Trial) Am J Obstet Gynecol. 2004;191:1446–1451. - PubMed
    1. Smith GCS, Stenhouse EJ, Crossley JA, et al. Early pregnancy levels of pregnancy-associated plasma protein A and the risk of intrauterine growth restriction, premature birth, preeclampsia and stillbirth. J Clin Endocrinol Metab. 2002;87:1762–1767. - PubMed
    1. Ong CYT, Liao AW, Spencer K, et al. First trimester maternal serum free β human chorionic gonadotrophin and pregnancy associated plasma protein A as predictors of pregnancy complications. BJOG. 2000;107:1265–1270. - PubMed

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