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First Trimester Prediction of Preeclampsia.

Dolberg Anderson, Ulrik LU ; Gram, Magnus LU ; Åkerström, Bo LU and Hansson, Stefan R LU (2015) In Current Hypertension Reports 17(9). p.74-74
Abstract
Preeclampsia (PE) is a serious pregnancy-related condition that causes severe maternal and fetal morbidity and mortality. Within the recent years, there has been an increasing focus in predicting PE at the end of the first trimester of pregnancy. In this review, literature published between 2011 and 2015 was evaluated. In a total of six biomarker algorithms, for first and early second trimester, the prediction of preeclampsia is discussed. In addition, one randomized clinical trial was included. Several algorithms were based on placental biomarkers such as pregnancy-associated plasma protein A (PAPP-A), placental growth factor (PLGF), and soluble FMS-like tyrosine kinase 1 (s-FLT-1). The algorithms containing these biomarkers showed a high... (More)
Preeclampsia (PE) is a serious pregnancy-related condition that causes severe maternal and fetal morbidity and mortality. Within the recent years, there has been an increasing focus in predicting PE at the end of the first trimester of pregnancy. In this review, literature published between 2011 and 2015 was evaluated. In a total of six biomarker algorithms, for first and early second trimester, the prediction of preeclampsia is discussed. In addition, one randomized clinical trial was included. Several algorithms were based on placental biomarkers such as pregnancy-associated plasma protein A (PAPP-A), placental growth factor (PLGF), and soluble FMS-like tyrosine kinase 1 (s-FLT-1). The algorithms containing these biomarkers showed a high prediction rate (PR) for early onset PE, ranging from 44 to 92 % at 5 % false positive rate (FPR). New biomarkers suggest an alternative model based on free HbF and the heme scavenger alpha-1-microglobulin (A1M) with a prediction rate of 69 % at an FPR of 5 %. Interestingly, this model performs well without uterine artery Doppler pulsatility index (UtAD-PI), which is an advantage particularly if the screening method were to be implemented in developing countries. The randomized clinical trial showed a clear reduction in early onset PE as well as reducing preterm PE if identified high-risk pregnancies were treated with low-dose aspirin. In conclusion, PE prediction is now possible through several prediction algorithms and prophylaxis is beneficial in high-risk cases. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Current Hypertension Reports
volume
17
issue
9
pages
74 - 74
publisher
Current Medicine Group LLC
external identifiers
  • pmid:26232922
  • wos:000361174900007
  • scopus:84938309229
ISSN
1534-3111
DOI
10.1007/s11906-015-0584-7
language
English
LU publication?
yes
id
e4f3719f-599a-4567-91a8-61928fe04780 (old id 7845052)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/26232922?dopt=Abstract
date added to LUP
2015-09-03 19:21:38
date last changed
2017-10-29 03:02:22
@article{e4f3719f-599a-4567-91a8-61928fe04780,
  abstract     = {Preeclampsia (PE) is a serious pregnancy-related condition that causes severe maternal and fetal morbidity and mortality. Within the recent years, there has been an increasing focus in predicting PE at the end of the first trimester of pregnancy. In this review, literature published between 2011 and 2015 was evaluated. In a total of six biomarker algorithms, for first and early second trimester, the prediction of preeclampsia is discussed. In addition, one randomized clinical trial was included. Several algorithms were based on placental biomarkers such as pregnancy-associated plasma protein A (PAPP-A), placental growth factor (PLGF), and soluble FMS-like tyrosine kinase 1 (s-FLT-1). The algorithms containing these biomarkers showed a high prediction rate (PR) for early onset PE, ranging from 44 to 92 % at 5 % false positive rate (FPR). New biomarkers suggest an alternative model based on free HbF and the heme scavenger alpha-1-microglobulin (A1M) with a prediction rate of 69 % at an FPR of 5 %. Interestingly, this model performs well without uterine artery Doppler pulsatility index (UtAD-PI), which is an advantage particularly if the screening method were to be implemented in developing countries. The randomized clinical trial showed a clear reduction in early onset PE as well as reducing preterm PE if identified high-risk pregnancies were treated with low-dose aspirin. In conclusion, PE prediction is now possible through several prediction algorithms and prophylaxis is beneficial in high-risk cases.},
  author       = {Dolberg Anderson, Ulrik and Gram, Magnus and Åkerström, Bo and Hansson, Stefan R},
  issn         = {1534-3111},
  language     = {eng},
  number       = {9},
  pages        = {74--74},
  publisher    = {Current Medicine Group LLC},
  series       = {Current Hypertension Reports},
  title        = {First Trimester Prediction of Preeclampsia.},
  url          = {http://dx.doi.org/10.1007/s11906-015-0584-7},
  volume       = {17},
  year         = {2015},
}