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Rezende KBDC, Bornia RG, Rolnik DL, Amim J, Ladeira LP, Teixeira VM, da Cunha AJL. Performance of the first-trimester Fetal Medicine Foundation competing risks model for preeclampsia prediction: an external validation study in Brazil. AJOG GLOBAL REPORTS 2024; 4:100346. [PMID: 38694483 PMCID: PMC11061323 DOI: 10.1016/j.xagr.2024.100346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2024] Open
Abstract
BACKGROUND The current version of the Fetal Medicine Foundation competing risks model for preeclampsia prediction has not been previously validated in Brazil. OBJECTIVE This study aimed (1) to validate the Fetal Medicine Foundation combined algorithm for the prediction of preterm preeclampsia in the Brazilian population and (2) to describe the accuracy and calibration of the Fetal Medicine Foundation algorithm when considering the prophylactic use of aspirin by clinical criteria. STUDY DESIGN This was a cohort study, including consecutive singleton pregnancies undergoing preeclampsia screening at 11 to 14 weeks of gestation, examining maternal characteristics, medical history, and biophysical markers between October 2010 and December 2018 in a university hospital in Brazil. Risks were calculated using the 2018 version of the algorithm available on the Fetal Medicine Foundation website, and cases were classified as low or high risk using a cutoff of 1/100 to evaluate predictive performance. Expected and observed cases with preeclampsia according to the Fetal Medicine Foundation-estimated risk range (≥1 in 10; 1 in 11 to 1 in 50; 1 in 51 to 1 in 100; 1 in 101 to 1 in 150; and <1 in 150) were compared. After identifying high-risk pregnant women who used aspirin, the treatment effect of 62% reduction in preterm preeclampsia identified in the Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention trial was used to evaluate the predictive performance adjusted for the effect of aspirin. The number of potentially unpreventable cases in the group without aspirin use was estimated. RESULTS Among 2749 pregnancies, preterm preeclampsia occurred in 84 (3.1%). With a risk cutoff of 1/100, the screen-positive rate was 25.8%. The detection rate was 71.4%, with a false positive rate of 24.4%. The area under the curve was 0.818 (95% confidence interval, 0.773-0.863). In the risk range ≥1/10, there is an agreement between the number of expected cases and the number of observed cases, and in the other ranges, the predicted risk was lower than the observed rates. Accounting for the effect of aspirin resulted in an increase in detection rate and positive predictive values and a slight decrease in the false positive rate. With 27 cases of preterm preeclampsia in the high-risk group without aspirin use, we estimated that 16 of these cases of preterm preeclampsia would have been avoided if this group had received prophylaxis. CONCLUSION In a high-prevalence setting, the Fetal Medicine Foundation algorithm can identify women who are more likely to develop preterm preeclampsia. Not accounting for the effect of aspirin underestimates the screening performance.
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Affiliation(s)
- Karina Bilda de Castro Rezende
- Clinical Medicine Postgraduate Program, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Drs Rezende and da Cunha)
- Maternity School of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Drs Rezende, Bornia, Amim, and Ladeira and XX Teixeira)
- Multidisciplinary Laboratory of Epidemiology and Health – LAMPES, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Dr Rezende and da Cunha)
| | - Rita G. Bornia
- Maternity School of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Drs Rezende, Bornia, Amim, and Ladeira and XX Teixeira)
- Professional Master Perinatal Health, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Drs Bornia and Amim)
| | - Daniel L. Rolnik
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia (Drs Rolnik)
| | - Joffre Amim
- Maternity School of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Drs Rezende, Bornia, Amim, and Ladeira and XX Teixeira)
- Professional Master Perinatal Health, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Drs Bornia and Amim)
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Dr Amim, XX Teixeira, and Dr da Cunha)
| | - Luiza P. Ladeira
- Maternity School of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Drs Rezende, Bornia, Amim, and Ladeira and XX Teixeira)
- Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil (Dr Ladeira)
| | - Valentina M.G. Teixeira
- Maternity School of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Drs Rezende, Bornia, Amim, and Ladeira and XX Teixeira)
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Dr Amim, XX Teixeira, and Dr da Cunha)
| | - Antonio Jose L.A. da Cunha
- Clinical Medicine Postgraduate Program, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Drs Rezende and da Cunha)
- Multidisciplinary Laboratory of Epidemiology and Health – LAMPES, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Dr Rezende and da Cunha)
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Dr Amim, XX Teixeira, and Dr da Cunha)
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Ohkuchi A, Takahashi K, Hirashima C, Suzuki H, Takahashi H, Nagayama S, Ogoyama M, Horie K, Usui R, Fujiwara H. Automated electrochemiluminescence immunoassay for serum PlGF levels in women with singleton pregnancy at 9-13 weeks of gestation predicts preterm preeclampsia: a retrospective cohort study. Hypertens Res 2024; 47:1196-1207. [PMID: 38135845 DOI: 10.1038/s41440-023-01534-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/27/2023] [Accepted: 11/15/2023] [Indexed: 12/24/2023]
Abstract
Our aims were to obtain the gestational-age-specific median of common logarithmic placental growth factor (PlGF) values in the first trimester in women with a singleton pregnancy in order to generate the gestational-age-specific multiple of the median (MoM) of log10PlGF at 9-13 weeks of gestation, to evaluate screening parameters of MoM of log10PlGF at 9-13 weeks of gestation to predict preterm preeclampsia (PE), and to construct an appropriate prediction model for preterm PE using minimum risk factors in multivariable logistic regression analyses in a retrospective sub-cohort study. Preterm PE occurred in 2.9% (20/700), and PE in 5.1% (36/700). Serum PlGF levels were measured using Elecsys PlGF®. MoMs of log10PlGF at 9-13 weeks of gestation in Japanese women with a singleton pregnancy followed a normal distribution. We determined the appropriate cut-off value of MoM of log10PlGF to predict preterm PE at around a10% false-positive rate (0.854). The MoM of log10PlGF < 0.854 yielded sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio (95% confidence interval [CI]), and negative likelihood ratio (95% CI) of 55.0%, 91.9%, 17.5%, 98.5%, 6.79 (4.22-10.91), and 0.49 (0.30-0.80), respectively. The combination of MoM of log10PlGF and presence of either chronic hypertension or history of PE/gestational hypertension (GH) yielded sensitivity and specificity of 80.0 and 85.7%, respectively, to predict preterm PE. In conclusion, the automated electrochemiluminescence immunoassay for serum PlGF levels in women with singleton pregnancy at 9-13 weeks of gestation may be useful to predict preterm PE.
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Affiliation(s)
- Akihide Ohkuchi
- Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Shimotsuke-shi, Tochigi, 329-0498, Japan.
| | - Kayo Takahashi
- Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Chikako Hirashima
- Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Hirotada Suzuki
- Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Hironori Takahashi
- Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Shiho Nagayama
- Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Manabu Ogoyama
- Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Kenji Horie
- Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Rie Usui
- Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Hiroyuki Fujiwara
- Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Shimotsuke-shi, Tochigi, 329-0498, Japan
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Izumi S, Iwama N, Metoki H. Prediction of preterm preeclampsia risk in Asians using a simple two-item assessment in early pregnancy. Hypertens Res 2024; 47:1231-1234. [PMID: 38321104 DOI: 10.1038/s41440-024-01590-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 12/30/2023] [Indexed: 02/08/2024]
Affiliation(s)
- Seiya Izumi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Sendai, 980-8574, Miyagi, Japan
| | - Noriyuki Iwama
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Sendai, 980-8574, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Sendai, 980-8573, Miyagi, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Sendai, 980-8573, Miyagi, Japan.
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical Pharmaceutical University, 1-15-1 Fukumuro, Sendai, 983-8536, Miyagi, Japan.
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Lendoye E, Minkobame UP, Makoyo Komba O, Assoumou Obiang P, Nkene Eya'a L, Bisvigou U, Moukambi L, Ndeboko B, Ntamack JAB, Ngoungou EB, Siawaya JFD, Abessolo FO, Meyé JF. Added Value of Mean Blood Pressure and Placental Growth Factor in the Early Detection of Pre-eclampsia among Gabonese Women. Niger Postgrad Med J 2024; 31:69-75. [PMID: 38321799 DOI: 10.4103/npmj.npmj_232_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/05/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVE To evaluate the use of the Foetal Medicine Foundation (FMF) algorithm in routine practice for early pre-eclampsia (PE) screening in Libreville. MATERIALS AND METHODS We conducted a cohort study on pregnant women within their 11-13 + 6 weeks of gestation (WG). We had measured mean blood pressure (MBP), placental growth factor (PlGF), soluble Fms-like tyrosine kinase 1, Uterine Artery Pulsatility Index (UtA-PI) and resistance index (UtA-RI). Statistical analyses were considered significant for P < 0.05. RESULTS There were 30 participants. At the first quarter (T1), 36.7% of them were at high risk of PE according to the FMF algorithm and were consequently prescribed aspirin (100 mg/d). By the end of the observation period, we have found a 13% incidence of PE. MBP was higher in the higher risk PE group than in the lower risk group as early as the T1 (90 ± 6 vs. 81 ± 6 mmHg; P = 0.0007, threshold is >86 mmHg/area under the curve (AUC) = 0.86; P = 0.0012). It was the same for PlGF (58 ± 24 vs. 88 ± 38 pg/ml; P = 0.03; threshold is <71.98 pg/ml/AUC = 0.73; P = 0.03). At the second quarter (20-27 WG), biochemical markers did not change between the two groups. UtA-RI, UtA-PI and notch were unconclusive individually, but they are still very important for FMF algorithm application. CONCLUSION Early detection of PE using the FMF algorithm is possible in routine practice in Gabon. MBP and PlGF levels at T1 seem to be very significant. However, the present study must continue to obtain the larger cohorts that would achieve more conclusive statistical analyses.
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Affiliation(s)
- Elisabeth Lendoye
- Mother Pole, Laboratories Service, Mother and Child University Hospital-Jeanne Ebori Foundation, Libreville, Gabon
- Department of Basic and Mixed Sciences, Chemistry-Biochemistry Service, Faculty of Medicine, University of Health Sciences, Libreville, Gabon
| | - Ulysse Pascal Minkobame
- Mother Pole, Gynecology-Obstetric Service, Mother and Child University Hospital-Jeanne Ebori Foundation, Libreville, Gabon
| | - Opheelia Makoyo Komba
- Mother Pole, Gynecology-Obstetric Service, Mother and Child University Hospital-Jeanne Ebori Foundation, Libreville, Gabon
| | - Pamphile Assoumou Obiang
- Mother Pole, Gynecology-Obstetric Service, Mother and Child University Hospital-Jeanne Ebori Foundation, Libreville, Gabon
| | - Luce Nkene Eya'a
- Mother Pole, Laboratories Service, Mother and Child University Hospital-Jeanne Ebori Foundation, Libreville, Gabon
- Mother Pole, Gynecology-Obstetric Service, Mother and Child University Hospital-Jeanne Ebori Foundation, Libreville, Gabon
| | - Ulrich Bisvigou
- Department of Community and Social Health, Epidemiology of Chronic Diseases and Environmental Health Research Unit, Faculty of Medicine, University of Health Sciences, Libreville, Gabon
| | - Lydie Moukambi
- Mother Pole, Laboratories Service, Mother and Child University Hospital-Jeanne Ebori Foundation, Libreville, Gabon
| | - Bénédicte Ndeboko
- Mother Pole, Laboratories Service, Mother and Child University Hospital-Jeanne Ebori Foundation, Libreville, Gabon
| | - Jacques Albert Bang Ntamack
- Mother Pole, Gynecology-Obstetric Service, Mother and Child University Hospital-Jeanne Ebori Foundation, Libreville, Gabon
| | - Edgard Brice Ngoungou
- Department of Community and Social Health, Epidemiology of Chronic Diseases and Environmental Health Research Unit, Faculty of Medicine, University of Health Sciences, Libreville, Gabon
| | - Joël Fleury Djoba Siawaya
- Mother Pole, Laboratories Service, Mother and Child University Hospital-Jeanne Ebori Foundation, Libreville, Gabon
| | - Félix Ovono Abessolo
- Department of Basic and Mixed Sciences, Chemistry-Biochemistry Service, Faculty of Medicine, University of Health Sciences, Libreville, Gabon
| | - Jean François Meyé
- Mother Pole, Gynecology-Obstetric Service, Mother and Child University Hospital-Jeanne Ebori Foundation, Libreville, Gabon
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Riishede I, Rode L, Sperling L, Overgaard M, Ravn JD, Sandager P, Skov H, Wagner SR, Nørgaard P, Clausen TD, Jensen CAJ, Pihl K, Jørgensen FS, Munk JK, Zingenberg HJ, Pedersen NG, Andersen MR, Wright A, Wright D, Tabor A, Ekelund CK. Pre-eclampsia screening in Denmark (PRESIDE): national validation study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 61:682-690. [PMID: 36840981 DOI: 10.1002/uog.26183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/19/2023] [Accepted: 02/13/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVES To investigate the predictive performance of the Fetal Medicine Foundation (FMF) first-trimester screening algorithm for pre-eclampsia in a Danish population and compare screening performance with that of the current Danish strategy, which is based on maternal risk factors. METHODS This was a prospective study of women with a singleton pregnancy attending for their first-trimester ultrasound scan and screening for aneuploidies at six Danish university hospitals between May 2019 and December 2020. Prenatal data on maternal characteristics and medical history were recorded, and measurements of mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), serum pregnancy-associated plasma protein-A (PAPP-A) and serum placental growth factor (PlGF) were collected without performing a risk assessment for pre-eclampsia. Information on acetylsalicylic acid use was recorded. After delivery, pregnancy outcome, including gestational age at delivery and pre-eclampsia diagnosis, was recorded. Pre-eclampsia risk assessment for each woman was calculated blinded to outcome using the FMF screening algorithm following adjustment to the Danish population. Detection rates (DRs) of the FMF algorithm were calculated for a fixed screen-positive rate (SPR) of 10% and for the SPR achieved in the current Danish screening. RESULTS A total of 8783 pregnant women were included, with a median age of 30.8 (interquartile range (IQR), 28.1-33.9) years. The majority were white (95%), naturally conceiving (90%), non-smokers (97%) and had no family history of pre-eclampsia (96%). The median body mass index was 23.4 (IQR, 21.2-26.6) kg/m2 . A complete risk assessment including maternal characteristics, MAP, UtA-PI, PlGF and PAPP-A was available for 8156 women (92.9%). In these women, UtA-PI was measured bilaterally with a median value of 1.58 (IQR, 1.27-1.94) and the median resting MAP of 80.5 (IQR, 76.1-85.4) mmHg in two consecutive measurements. Among these, 303 (3.7%) developed pre-eclampsia, including 55 (0.7%) cases of pre-eclampsia with delivery < 37 weeks of gestation and 16 (0.2%) cases of pre-eclampsia with delivery < 34 weeks. At a SPR of 10%, combined screening using the FMF algorithm based on maternal characteristics, MAP, UtA-PI, PlGF and PAPP-A had a DR of 77.4% (95% CI, 57.6-97.2%) for pre-eclampsia with delivery < 34 weeks, 66.8% (95% CI, 54.4-79.1%) for pre-eclampsia with delivery < 37 weeks and 44.1% (95% CI, 38.5-49.7%) for pre-eclampsia with delivery at any gestational age. The current Danish screening strategy using maternal risk factors detected 25.0% of women with pre-eclampsia with delivery < 34 weeks and 19.6% of women with pre-eclampsia with delivery < 37 weeks at a SPR of 3.4%. When applying the FMF algorithm including maternal characteristics, MAP, UtA-PI and PlGF at the fixed SPR of 3.4%, the DRs were 60.5% (95% CI, 36.9-84.1%) for PE with delivery < 34 weeks and 45.2% (95% CI, 32.0-58.5%) for PE with delivery < 37 weeks. CONCLUSION In this large Danish multicenter study, the FMF algorithm based on maternal characteristics, MAP, UtA-PI, PlGF and PAPP-A predicted 77.4% of cases with pre-eclampsia with delivery < 34 weeks and 66.8% of cases with pre-eclampsia with delivery < 37 weeks of gestation at a SPR of 10%, suggesting that the performance of the algorithm in a Danish cohort matches that in other populations. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- I Riishede
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Obstetrics, Center of Fetal Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - L Rode
- Department of Obstetrics, Center of Fetal Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - L Sperling
- Department of Obstetrics and Gynecology, Fetal Medicine Unit, Odense University Hospital, Odense, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - M Overgaard
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Department of Clinical Biochemistry, Odense University Hospital, Odense, Denmark
| | - J D Ravn
- Department of Obstetrics and Gynecology, Fetal Medicine Unit, Odense University Hospital, Odense, Denmark
| | - P Sandager
- Department of Obstetrics and Gynecology, Center of Fetal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - H Skov
- Department of Obstetrics and Gynecology, Center of Fetal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - S R Wagner
- Biomedical Engineering Section, Department of Electrical and Computer Engineering, Aarhus University, Aarhus, Denmark
| | - P Nørgaard
- Department of Obstetrics and Gynecology, Copenhagen University Hospital North Zealand, Hillerød, Denmark
| | - T D Clausen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Obstetrics and Gynecology, Copenhagen University Hospital North Zealand, Hillerød, Denmark
| | - C A Juel Jensen
- Department of Clinical Biochemistry, Copenhagen University Hospital North Zealand, Hillerød, Denmark
| | - K Pihl
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - F S Jørgensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - J K Munk
- Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - H J Zingenberg
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - N G Pedersen
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - M R Andersen
- Department of Clinical Biochemistry, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
| | - A Wright
- Institute of Health Research, University of Exeter, Exeter, UK
| | - D Wright
- Institute of Health Research, University of Exeter, Exeter, UK
| | - A Tabor
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Obstetrics, Center of Fetal Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - C K Ekelund
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Obstetrics, Center of Fetal Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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Predictive ability of serum advanced glycation end products at 11–13 weeks of gestation for early-onset pre-eclampsia. AJOG GLOBAL REPORTS 2022; 2:100052. [PMID: 36275494 PMCID: PMC9563657 DOI: 10.1016/j.xagr.2022.100052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AGEs at 11 to 13 weeks of gestation were significantly higher in patients with EOPE. AUROC curve for the AGE-to-PlGF ratio was significantly higher than that of AGEs. The AGE-to-PlGF ratio and MAP detected EOPE with 100% accuracy (FPR of 10%).
BACKGROUND Placental hypoxia and resultant oxidative stress have been associated with the development of preeclampsia. Oxidative stress promotes the formation of advanced glycation end products. OBJECTIVE This study aimed to assess whether serum levels of advanced glycation end products during the early stage of pregnancy are a predictive biomarker of early-onset and late-onset preeclampsia. STUDY DESIGN This was a nested case-control study that included 6 women with early-onset preeclampsia, 21 women with late-onset preeclampsia, and 50 age- and body mass index–matched healthy female control subjects. All women enrolled in the study had a complete medical history, including mean arterial pressure and uterine artery pulsatility index measurements. Furthermore, the women underwent blood chemistry analysis, including circulating levels of advanced glycation end products, soluble fms-like tyrosine kinase-1, and placental growth factor. Clinical measurements and biochemistry were evaluated at 11 to 13 and 19 to 24 weeks of gestation. RESULTS The median serum concentrations of advanced glycation end products at 11 to 13 weeks of gestation were significantly higher in patients with early-onset preeclampsia than in those with late-onset preeclampsia and control subjects (6.62 vs 4.10 vs 3.77; P<.05), but no significant difference was found in advanced glycation end products at 19 to 24 weeks of gestation among the 3 groups. The advanced glycation end product–to–placental growth factor ratio in the first trimester of pregnancy was significantly higher in patients with early-onset preeclampsia than in those with late-onset preeclampsia or control subjects (0.78 vs 0.10 vs 0.10; P<.05). The area under the receiver operating characteristic curve values for patients with early-onset preeclampsia were 0.782 (95% confidence interval, 0.522–0.922), 0.855 (95% confidence interval, 0.433–0.978), and 0.925 (95% confidence interval, 0.724–0.983) for the advanced glycation end product and placental growth factor levels and advanced glycation end product–to–placental growth factor ratios, respectively. This population achieved a 100% detection rate for predicting early-onset preeclampsia at a screen-positive rate of 10% by combining the advanced glycation end product–to–placental growth factor ratio and the mean arterial pressure. CONCLUSION The study results suggested that an elevated advanced glycation end product–to–placental growth factor ratio and mean arterial pressure at 11 to 13 weeks of gestation could be a potential biomarker for predicting the future development of early-onset preeclampsia.
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Mogi M, Higashi Y, Bokuda K, Ichihara A, Nagata D, Tanaka A, Node K, Nozato Y, Yamamoto K, Sugimoto K, Shibata H, Hoshide S, Nishizawa H, Kario K. Annual reports on hypertension research 2020. Hypertens Res 2022; 45:15-31. [PMID: 34650193 DOI: 10.1038/s41440-021-00766-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 02/08/2023]
Abstract
In 2020, 199 papers were published in Hypertension Research. Many excellent papers have contributed to progress in research on hypertension. Here, our editorial members have summarized eleven topics from published work and discussed current topics in depth. We hope you enjoy our special feature, Annual Reports on Hypertension Research.
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Affiliation(s)
- Masaki Mogi
- Deparment of Pharmacology, Ehime University Graduate School of Medicine, Tohon, Ehime, Japan.
| | - Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Hiroshima, Japan.,Divivsion of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
| | - Kanako Bokuda
- Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
| | - Atsuhiro Ichihara
- Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
| | - Daisuke Nagata
- Division of Nephrology, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, Saga, Saga, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Saga, Japan
| | - Yoichi Nozato
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Koichi Yamamoto
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Ken Sugimoto
- General and Geriatric Medicine, Kawasaki Medical University, Okayama, Okayama, Japan
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Oita, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Hitoshi Nishizawa
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
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