A prospective study of screening for preeclampsia at 11-13 weeks in a Russian population

Abstract

Objective: To investigate the prediction of preeclampsia using maternal characteristics, mean arterial pressure (MAP), uterine artery pulsatility index (UtAPI), pregnancy-associated plasma protein-A (PAPP-A), placental growth factor (PlGF) at gestational weeks 11-13 in a Russian population with low to medium risk for developing hypertensive disorders of pregnancy. Design: Prospective screening study. Setting: Federal Clinical Center for Obstetrics, Gynecology & Perinatology, Moscow, Russia. Population: All women who attended first trimester aneuploidy screening at the Clinic from August 2013 to May 2015. Methods: Women were examined between 11 + 0 and 13 + 6 weeks, with interviews for a priori clinical characteristics and measurements of MAP, UtAP, PAPP-A and PlGF. Main outcome measures: Prediction of preeclampsia requiring delivery before 34 weeks (early-onset PE), after 34 weeks (late-onset PE). Results: A total of 2949 woman were screened and delivered locally. 2917 (98,9%) women had all data to perform preeclampsia screening available. This included 2851 (97,7%) women with a live birth, where risk of preeclampsia were calculated. 23 women were delivered before 34 weeks because of early preeclampsia with prevalence of early PE of 0.8%; 39 women (1,4%) were delivered after 34 weeks. Risk generated through the use of maternal history, MAP, UtAPI, PAPP-A and PlGF detected 87,3% of early PE and 49,8% of late PE at a false-positive rate of 10%. Conclusion: This study shows that the combined assessment (maternal characteristics, MAP, UtAPI, PAPP-A and PlGF) showed moderate effectiveness as first trimester screening test for PE in a Russian population. Further research on biochemical and biophysical test is required to determine the optimal way to predict PE.