Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar;26(1):155-162.
doi: 10.1007/s40477-022-00697-w. Epub 2022 Aug 2.

Ophthalmic artery Doppler for pre-eclampsia prediction at the first trimester: a Bayesian survival-time model

Raden Aditya Kusuma  1   2 , Detty Siti Nurdiati  3 , Adly Nanda Al Fattah  4   5 , Didi Danukusumo  6 , Sarini Abdullah  7 , Ivan Sini  8   9
Affiliations

Ophthalmic artery Doppler for pre-eclampsia prediction at the first trimester: a Bayesian survival-time model

Raden Aditya Kusuma et al. J Ultrasound. 2023 Mar.

Abstract

Objective: To develop a Bayesian survival-time model for the prediction of pre-eclampsia (PE) at the first trimester using a combination of established biomarkers including maternal characteristics and history, mean arterial pressure (MAP), uterine artery Doppler pulsatility index (UtA-PI), and Placental Growth Factor (PlGF)) with an ophthalmic artery Doppler peak ratio (PR) analysis.

Methods: The receiving operator curve (ROC) analysis was used to determine the area under the curve (AUC), detection rate (DR), and positive screening cut-off value of the model in predicting the occurrence of early-onset PE (< 34 weeks' gestation) and preterm PE (< 37 weeks' gestation).

Results: Of the 946 eligible participants, 71 (7.49%) subjects were affected by PE. The incidences of early-onset and preterm PE were 1% and 2.2%, respectively. At a 10% false-positive rate, using the high-risk cut-off 1:49, with AUC 0.981 and 95%CI 0.965-0.998, this model had an 100% of DR in predicting early-onset PE. The DR of this model in predicting preterm PE is 71% when using 1:13 as the cut-off, with AUC 0.919 and 95%CI 0.875-0.963.

Conclusion: Combination ophthalmic artery Doppler PR with the previously established biomarkers could improve the accuracy of early and preterm PE prediction at the first trimester screening.

Keywords: Bayesian; Ophthalmic artery; Pre-eclampsia; Survival model.

PubMed Disclaimer

Conflict of interest statement

The authors declared that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Ophthalmic artery Doppler assessment. At the bottom is the waveform of the ophthalmic artery obtained by pulsed Doppler illustrating the first and second peak systolic velocity
Fig. 2
Fig. 2
Survival analysis curve of gestational age at delivery from PE and non-PE group
Fig. 3
Fig. 3
Effect of categorical variables on gestational age at delivery with PE
Fig. 4
Fig. 4
ROC curve of our model to predict early-onset PE (AUC =0.981, 95%CI 0.965–0.998)
Fig. 5
Fig. 5
ROC curve of our model to predict preterm PE (AUC =0.919, 95%CI 0.875–0.963)
See this image and copyright information in PMC

References

    1. Abalos E, Cuesta C, Grosso AL, Chou D, Say L. Global and regional estimates of preeclampsia and eclampsia: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):1–7. doi: 10.1016/j.ejogrb.2013.05.005. - DOI - PubMed
    1. Poon LC, Shennan A, Hyett JA, Kapur A, Hadar E, Divakar H, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: a pragmatic guide for first-trimester screening and prevention. Int J Gynecol Obstet. 2019;145(S1):1–33. doi: 10.1002/ijgo.12802. - DOI - PMC - PubMed
    1. Akolekar R, Syngelaki A, Poon L, Wright D, Nicolaides KH. Competing risks model in early screening for preeclampsia by biophysical and biochemical markers. Fetal Diagn Ther. 2013;33(1):8–15. doi: 10.1159/000341264. - DOI - PubMed
    1. Baschat AA, Magder LS, Doyle LE, Atlas RO, Jenkins CB, Blitzer MG. Prediction of preeclampsia utilizing the first trimester screening examination. Am J Obstet Gynecol. 2014;211(5):514.e1–514.e7. doi: 10.1016/j.ajog.2014.04.018. - DOI - PubMed
    1. Poon LCY, Maiz N, Valencia C, Plasencia W, Nicolaides KH. First-trimester maternal serum pregnancy-associated plasma protein-A and pre-eclampsia. Ultrasound Obstet Gynecol. 2009;33(1):23–33. doi: 10.1002/uog.6280. - DOI - PubMed