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Performance of Fetal Medicine Foundation algorithm for first trimester preeclampsia screening in an indigenous south Asian population
BACKGROUND: To evaluate the performance of the Fetal Medicine Foundation (FMF) preterm preeclampsia (PE) screening algorithm in an indigenous South Asian population. METHODS: This was a prospective observational cohort study conducted in a tertiary maternal fetal unit in Delhi, India over 2 years. T...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8642869/ https://www.ncbi.nlm.nih.gov/pubmed/34863125 http://dx.doi.org/10.1186/s12884-021-04283-6 |
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author | Prasad, Smriti Sahota, Daljit Singh Vanamail, P. Sharma, Akshatha Arora, Saloni Kaul, Anita |
author_facet | Prasad, Smriti Sahota, Daljit Singh Vanamail, P. Sharma, Akshatha Arora, Saloni Kaul, Anita |
author_sort | Prasad, Smriti |
collection | PubMed |
description | BACKGROUND: To evaluate the performance of the Fetal Medicine Foundation (FMF) preterm preeclampsia (PE) screening algorithm in an indigenous South Asian population. METHODS: This was a prospective observational cohort study conducted in a tertiary maternal fetal unit in Delhi, India over 2 years. The study population comprised of 1863 women carrying a singleton pregnancy and of South Asian ethnicity who were screened for preterm pre-eclampsia (PE) between 11 and 14 weeks of gestation using Mean Arterial Pressure (MAP), transvaginal Mean Uterine Artery Pulsatility Index (UtAPI) and biochemical markers - Pregnancy Associated Plasma Protein-A (PAPP-A) and Placental Growth Factor.. Absolutemeasurements of noted biomarkers were converted to multiples of the expected gestational median (MoMS) which were then used to estimate risk for preterm PE < 37 weeks using Astraia software. Women with preterm PE risk of ≥1:100 was classified as as high risk. Detection rates (DR) at 10% false positive rate were calculated after adjusting for prophylactic aspirin use (either 75 or 150 mg). RESULTS: The incidence of PE and preterm PE were 3.17% (59/1863) and 1.34% (25/1863) respectively. PAPP-A and PlGF MoM distribution medians were 0.86 and 0.87 MoM and significantly deviated from 1 MoM. 431 (23.1%) women had a risk of ≥1:100, 75 (17.8%) of who received aspirin. Unadjusted DR using ≥1:100 threshold was 76%.Estimated DRs for a fixed 10% FPR ranged from 52.5 to 80% depending on biomarker combination after recentering MoMs and adjusting for aspirin use. CONCLUSION: The FMF algorithm whilst performing satisfactorily could still be further improved to ensure that biophysical and biochemical markers are correctly adjusted for indigenous South Asian women. |
format | Online Article Text |
id | pubmed-8642869 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-86428692021-12-06 Performance of Fetal Medicine Foundation algorithm for first trimester preeclampsia screening in an indigenous south Asian population Prasad, Smriti Sahota, Daljit Singh Vanamail, P. Sharma, Akshatha Arora, Saloni Kaul, Anita BMC Pregnancy Childbirth Research BACKGROUND: To evaluate the performance of the Fetal Medicine Foundation (FMF) preterm preeclampsia (PE) screening algorithm in an indigenous South Asian population. METHODS: This was a prospective observational cohort study conducted in a tertiary maternal fetal unit in Delhi, India over 2 years. The study population comprised of 1863 women carrying a singleton pregnancy and of South Asian ethnicity who were screened for preterm pre-eclampsia (PE) between 11 and 14 weeks of gestation using Mean Arterial Pressure (MAP), transvaginal Mean Uterine Artery Pulsatility Index (UtAPI) and biochemical markers - Pregnancy Associated Plasma Protein-A (PAPP-A) and Placental Growth Factor.. Absolutemeasurements of noted biomarkers were converted to multiples of the expected gestational median (MoMS) which were then used to estimate risk for preterm PE < 37 weeks using Astraia software. Women with preterm PE risk of ≥1:100 was classified as as high risk. Detection rates (DR) at 10% false positive rate were calculated after adjusting for prophylactic aspirin use (either 75 or 150 mg). RESULTS: The incidence of PE and preterm PE were 3.17% (59/1863) and 1.34% (25/1863) respectively. PAPP-A and PlGF MoM distribution medians were 0.86 and 0.87 MoM and significantly deviated from 1 MoM. 431 (23.1%) women had a risk of ≥1:100, 75 (17.8%) of who received aspirin. Unadjusted DR using ≥1:100 threshold was 76%.Estimated DRs for a fixed 10% FPR ranged from 52.5 to 80% depending on biomarker combination after recentering MoMs and adjusting for aspirin use. CONCLUSION: The FMF algorithm whilst performing satisfactorily could still be further improved to ensure that biophysical and biochemical markers are correctly adjusted for indigenous South Asian women. BioMed Central 2021-12-04 /pmc/articles/PMC8642869/ /pubmed/34863125 http://dx.doi.org/10.1186/s12884-021-04283-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Prasad, Smriti Sahota, Daljit Singh Vanamail, P. Sharma, Akshatha Arora, Saloni Kaul, Anita Performance of Fetal Medicine Foundation algorithm for first trimester preeclampsia screening in an indigenous south Asian population |
title | Performance of Fetal Medicine Foundation algorithm for first trimester preeclampsia screening in an indigenous south Asian population |
title_full | Performance of Fetal Medicine Foundation algorithm for first trimester preeclampsia screening in an indigenous south Asian population |
title_fullStr | Performance of Fetal Medicine Foundation algorithm for first trimester preeclampsia screening in an indigenous south Asian population |
title_full_unstemmed | Performance of Fetal Medicine Foundation algorithm for first trimester preeclampsia screening in an indigenous south Asian population |
title_short | Performance of Fetal Medicine Foundation algorithm for first trimester preeclampsia screening in an indigenous south Asian population |
title_sort | performance of fetal medicine foundation algorithm for first trimester preeclampsia screening in an indigenous south asian population |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8642869/ https://www.ncbi.nlm.nih.gov/pubmed/34863125 http://dx.doi.org/10.1186/s12884-021-04283-6 |
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