Prediction of Small-for-Gestation Neonates from Biophysical and Biochemical Markers at 11-13 Weeks

被引:142
作者
Karagiannis, George [1 ]
Akolekar, Ranjit [1 ]
Sarquis, Rita [1 ,2 ]
Wright, David [3 ]
Nicolaides, Kypros H. [1 ,2 ]
机构
[1] Kings Coll Hosp London, Harris Birthright Res Ctr Fetal Med, London SE5 9RS, England
[2] Univ Coll London Hosp, Dept Fetal Med, London, England
[3] Univ Plymouth, Dept Math & Stat, Plymouth PL4 8AA, Devon, England
关键词
First-trimester screening; Fetal growth restriction; Small-for-gestational age; Nuchal translucency; Uterine artery Doppler; Serum biochemistry; NUCHAL-TRANSLUCENCY THICKNESS; PLACENTAL GROWTH-FACTOR; HUMAN CHORIONIC-GONADOTROPIN; PLASMA PROTEIN-A; MATERNAL SERUM; SPIRAL ARTERIES; AGE FETUSES; PAPP-A; PREGNANCY; PREECLAMPSIA;
D O I
10.1159/000321694
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To develop a model for prediction of small-for-gestational age (SGA) neonates in the absence of preeclampsia (PE) based on maternal factors and biophysical and biochemical markers at 11-13 weeks' gestation. Methods: Screening study in 1,536 SGA and 31,314 non-SGA pregnancies based on maternal characteristics, fetal nuchal translucency (NT) thickness, serum pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotrophin (beta-hCG). We also measured mean arterial pressure (MAP), uterine artery pulsatility index (PI) and performed case-control studies for measurement of maternal serum concentration of placental growth factor (PLGF), placental protein 13 (PP13) and A Disintegrin And Metalloprotease (ADAM12). Regression analysis was used to develop a model for the prediction of SGA. Results: In the SGA group, uterine artery PI and MAP were increased and serum PAPP-A, free beta-hCG, PLGF, PP13, and ADAM12 and fetal NT were decreased. At a false positive rate of 10%, the estimated detection rate by a combination of maternal factors and biophysical and biochemical markers at 11-13 weeks was 73% for SGA requiring delivery before 37 weeks and 46% for those delivering at term. Conclusions: Half of pregnancies with SGA neonates in the absence of PE could potentially be identified at 11-13 weeks. Copyright (C) 2010 S. Karger AG, Basel
引用
收藏
页码:148 / 154
页数:7
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