A prediction model for stillbirth based on first trimester pre-eclampsia combined screening.

Autor: Al-Fattah AN; Indonesian Prenatal Institute, Jakarta, Indonesia.; Kosambi Maternal and Child Center, Jakarta, Indonesia., Mahindra MP; Indonesian Prenatal Institute, Jakarta, Indonesia.; Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK., Yusrika MU; Indonesian Prenatal Institute, Jakarta, Indonesia., Mapindra MP; Indonesian Prenatal Institute, Jakarta, Indonesia.; Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK., Marizni S; Indonesian Prenatal Institute, Jakarta, Indonesia., Putri VP; Indonesian Prenatal Institute, Jakarta, Indonesia.; Kosambi Maternal and Child Center, Jakarta, Indonesia., Besar SP; Harapan Kita National Women and Children's Hospital, Jakarta, Indonesia., Widjaja FF; Indonesian Prenatal Institute, Jakarta, Indonesia., Kusuma RA; Indonesian Prenatal Institute, Jakarta, Indonesia.; Harapan Kita National Women and Children's Hospital, Jakarta, Indonesia., Siassakos D; Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2024 Dec; Vol. 167 (3), pp. 1101-1108. Date of Electronic Publication: 2024 Jul 04.
DOI: 10.1002/ijgo.15755
Abstrakt: Objective: To evaluate the accuracy of combined models of maternal biophysical factors, ultrasound, and biochemical markers for predicting stillbirths.
Methods: A retrospective cohort study of pregnant women undergoing first-trimester pre-eclampsia screening at 11-13 gestational weeks was conducted. Maternal characteristics and history, mean arterial pressure (MAP) measurement, uterine artery pulsatility index (UtA-PI) ultrasound, maternal ophthalmic peak ratio Doppler, and placental growth factor (PlGF) serum were collected during the visit. Stillbirth was classified as placental dysfunction-related when it occurred with pre-eclampsia or birth weight <10th percentile. Combined prediction models were developed from significant variables in stillbirths, placental dysfunction-related, and controls. We used the area under the receiver-operating-characteristics curve (AUC), sensitivity, and specificity based on a specific cutoff to evaluate the model's predictive performance by measuring the capacity to distinguish between stillbirths and live births.
Results: There were 13 (0.79%) cases of stillbirth in 1643 women included in the analysis. The combination of maternal factors, MAP, UtA-PI, and PlGF, significantly contributed to the prediction of stillbirth. This model was a good predictor for all (including controls) types of stillbirth (AUC 0.879, 95% CI: 0.799-0.959, sensitivity of 99.3%, specificity of 38.5%), and an excellent predictor for placental dysfunction-related stillbirth (AUC 0.984, 95% CI: 0.960-1.000, sensitivity of 98.5, specificity of 85.7).
Conclusion: Screening at 11-13 weeks' gestation by combining maternal factors, MAP, UtA-PI, and PlGF, can predict a high proportion of stillbirths. Our model has good accuracy for predicting stillbirths, predominantly placental dysfunction-related stillbirths.
(© 2024 The Author(s). International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.)
Databáze: MEDLINE
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