Pregnancy outcomes in nulliparous women with positive first-trimester preterm preeclampsia screening test: the Great Obstetrical Syndromes cohort study

BackgroundThe Fetal Medicine Foundation proposed a competing risks model for early identification of women at high risk preterm preeclampsia, typically associated with deep placentation disorders. The Great Obstetrical Syndromes include spectrum pregnancy complications (preeclampsia, intrauterine growth restriction, birth, late spontaneous abortion, and abruptio placentae) that are also disorders.ObjectiveThis study aimed to estimate the rate placenta-mediated in nulliparous positive first-trimester preeclampsia screening test.Study DesignWe conducted prospective cohort recruited 11 14 weeks gestation. Maternal characteristics, mean arterial blood pressure, levels maternal serum biomarkers (pregnancy-associated plasma protein-A, placental factor, soluble fms-like tyrosine kinase-1), uterine artery pulsatility index were obtained calculate according algorithm. predicted dichotomized as or negative test 2 cutoffs (1 70 1 100). detection rate, false-positive predictive values calculated complications, including small gestational age (birthweight <10th percentile), fetal death, composite outcome, any foregoing. same analyses computed severe outcomes, (less than third death.ResultsWe included 4575 participants complete observations, whom 494 (10.8%) had an estimated ≥1 728 (15.9%) 100. based on cutoff could have correctly up 27% 55% 18% age, 24% 37% deaths 10% rate. 100 35% 69% 25% 30% 53% 15% value was 3% 32% 9% outcome.ConclusionNulliparous higher both other complications. Approximately woman 10 identified by algorithm developed least complication. This test. We death. outcome. Nulliparous