Model for Early Prediction of Preeclampsia: A Nested Case Controlled Study in Indian Women.

Autor: Yadav S; Department of Pathology, King George's Medical University, Lucknow, U.P. India.; Department of Molecular Medicine & Biotechnology, Sanjay Gandhi Post Graduate Institute of Medical Science (SGPGIMS), 4th Floor PMSSY Building, Raebareli Rd, Lucknow, U.P. 226014 India., Khandpur S; Department of Molecular Medicine & Biotechnology, Sanjay Gandhi Post Graduate Institute of Medical Science (SGPGIMS), 4th Floor PMSSY Building, Raebareli Rd, Lucknow, U.P. 226014 India., Yadav YS; Department of Pediatrics, Uttar Pradesh University of Medical Science, Saifai, U.P. India., Goel MM; Department of Pathology, King George's Medical University, Lucknow, U.P. India., Singh U; Department of Obstetrics and Gynecology, King George's Medical University, Lucknow, U.P. India., Natu SM; Department of Pathology, King George's Medical University, Lucknow, U.P. India., Negi MPS; Institute for Data Computing & Training, Lucknow, U.P. India., Sharma LK; Department of Molecular Medicine & Biotechnology, Sanjay Gandhi Post Graduate Institute of Medical Science (SGPGIMS), 4th Floor PMSSY Building, Raebareli Rd, Lucknow, U.P. 226014 India., Tiwari S; Department of Molecular Medicine & Biotechnology, Sanjay Gandhi Post Graduate Institute of Medical Science (SGPGIMS), 4th Floor PMSSY Building, Raebareli Rd, Lucknow, U.P. 226014 India.
Jazyk: angličtina
Zdroj: Journal of obstetrics and gynaecology of India [J Obstet Gynaecol India] 2022 Aug; Vol. 72 (4), pp. 299-306. Date of Electronic Publication: 2021 Jun 29.
DOI: 10.1007/s13224-021-01511-z
Abstrakt: Purpose: Preeclampsia (PE) affects 5-7% of the pregnancies worldwide, and is one of the most dreaded disorders of pregnancy contributing to maternal and neonatal mortality. PE is mostly presented in the third trimester of pregnancy. Here, we used serum placental growth factor (PIGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) to develop a model for predicting PE in Indian women in early second trimester.
Methods: In this case-control study, a total 1452 healthy pregnant women were recruited. Blood samples were collected at the following gestational weeks (GWs), 12-20 (GW1), 21-28 (GW2) and 29-term (GW3), and post-delivery. Body mass index (BMI) was calculated by anthropometric measurements. Serum sFlt-1, PIGF and VEGF were analyzed by ELISA. A predictive model for PE was developed using multivariable logistic regression analysis.
Results: In PE cases, serum PlGF and VEGF levels were significantly lower at each GW, while serum sFlt-1 was lower only at GW1, relative to age-matched controls, ( n  = 132/group). Age-matched comparison between PE cases and controls indicated that sFlt-1 was associated with decreased PE outcome (Odds ratio. OR = 0.988, CI = 0.982-0.993), whereas sFlt-1/PlGF ratio (OR = 1.577, CI = 1.344-1.920) and BMI (OR = 1.334, CI = 1.187-1.520) were associated with increased PE outcome. Logistic regression was used to develop a predictive model for PE at GW1. Using testing dataset, model was externally validated which resulted in 88% accuracy in predicting PE cases at 0.5 probability cutoff.
Conclusion: Prediction model using sFlt-1, sFlt-1/PlGF ratio and BMI may be useful to predict PE as early as 12-20 weeks in women with optimal sensitivity and specificity.
Competing Interests: Conflict of interestAuthors declare that there are no conflicts of interest with regard to this manuscript.
(© Federation of Obstetric & Gynecological Societies of India 2021.)
Databáze: MEDLINE
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