Performance of Fetal Medicine Foundation algorithm for first trimester preeclampsia screening in an indigenous south Asian population

Abstract 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 y...

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Autores principales:	Smriti Prasad, Daljit Singh Sahota, P. Vanamail, Akshatha Sharma, Saloni Arora, Anita Kaul
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Pre-eclampsia South Asian Screening 1st trimester Uterine artery Pulsatility index Mean arterial pressure Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/0d6bc5e706ac4b50b1820f2dab0494f7
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spelling	oai:doaj.org-article:0d6bc5e706ac4b50b1820f2dab0494f72021-12-05T12:20:42ZPerformance of Fetal Medicine Foundation algorithm for first trimester preeclampsia screening in an indigenous south Asian population10.1186/s12884-021-04283-61471-2393https://doaj.org/article/0d6bc5e706ac4b50b1820f2dab0494f72021-12-01T00:00:00Zhttps://doi.org/10.1186/s12884-021-04283-6https://doaj.org/toc/1471-2393Abstract 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.Smriti PrasadDaljit Singh SahotaP. VanamailAkshatha SharmaSaloni AroraAnita KaulBMCarticlePre-eclampsiaSouth AsianScreening1st trimesterUterine artery Pulsatility indexMean arterial pressureGynecology and obstetricsRG1-991ENBMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Pre-eclampsia South Asian Screening 1st trimester Uterine artery Pulsatility index Mean arterial pressure Gynecology and obstetrics RG1-991
spellingShingle	Pre-eclampsia South Asian Screening 1st trimester Uterine artery Pulsatility index Mean arterial pressure Gynecology and obstetrics RG1-991 Smriti Prasad Daljit Singh Sahota P. Vanamail Akshatha Sharma Saloni Arora Anita Kaul Performance of Fetal Medicine Foundation algorithm for first trimester preeclampsia screening in an indigenous south Asian population
description	Abstract 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	article
author	Smriti Prasad Daljit Singh Sahota P. Vanamail Akshatha Sharma Saloni Arora Anita Kaul
author_facet	Smriti Prasad Daljit Singh Sahota P. Vanamail Akshatha Sharma Saloni Arora Anita Kaul
author_sort	Smriti Prasad
title	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_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_sort	performance of fetal medicine foundation algorithm for first trimester preeclampsia screening in an indigenous south asian population
publisher	BMC
publishDate	2021
url	https://doaj.org/article/0d6bc5e706ac4b50b1820f2dab0494f7
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Performance of Fetal Medicine Foundation algorithm for first trimester preeclampsia screening in an indigenous south Asian population

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