Prediction of Preeclampsia in Twins Using First Trimester: cffDNA Fraction, PlGF, and MAP.

IF 2.7 2区医学 Q2 GENETICS & HEREDITY

Prenatal Diagnosis Pub Date : 2025-05-21 DOI:10.1002/pd.6820

Ran Svirsky, Adi Sharabi-Nov, Ron Maymon, Nadav Kugler, Moran Landau Rabbi, Richard Brown, Heidy Portillo Rodriguez, Linda Peltier, Kypros Nicolaides, Hamutal Meiri

{"title":"Prediction of Preeclampsia in Twins Using First Trimester: cffDNA Fraction, PlGF, and MAP.","authors":"Ran Svirsky, Adi Sharabi-Nov, Ron Maymon, Nadav Kugler, Moran Landau Rabbi, Richard Brown, Heidy Portillo Rodriguez, Linda Peltier, Kypros Nicolaides, Hamutal Meiri","doi":"10.1002/pd.6820","DOIUrl":null,"url":null,"abstract":"Objectives: To evaluate cell-free fetal DNA fraction (cffDNAF) as a first-trimester screening marker for preeclampsia necessitating delivery before 37 weeks' gestation in twin pregnancies alone and combined with other bio-markers.Methods: Women with two live fetuses were enrolled in the first trimester, and evaluated for cffDNAF as a first trimester preeclampsia marker alone, and with placental growth factor (PlGF), mean arterial pressure (MAP), and uterine artery pulsatility index (UtA-PI).Results: There were 20 affected women; the cffDNAF was 9.0% (IQR: 8.4%-10.3%) in the affected, compared to 14% (IQR: 11%-16%) in 163 unaffected cases (p < 0.001). The AUROC for cffDNAF was 0.73 (95% CI: 0.61-0.85, p < 0.001), PlGF had an AUROC of 0.71 (0.59-0.83, p = 0.001), MAP had AUROC of 0.61 (0.50-0.72, p = 0.053) whereas UtA-PI had AUROC of 0.54 (0.39-0.69, p > 0.05). Combining all three biomarkers yielded an AUROC of 0.89 (0.78-0.98), with a sensitivity of 81%, specificity of 90%, negative predictive value (NPV) of 97.5%, and positive predictive value (PPV) of 50.7 UtA-PI did not contribute to the AUROC.Conclusion: In twin pregnancies low first trimester cffDNAF effectively screens for preeclampsia necessitating delivery before 37 weeks' gestation, which is augmented with PlGF and MAP.","PeriodicalId":20387,"journal":{"name":"Prenatal Diagnosis","volume":" ","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Prenatal Diagnosis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/pd.6820","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GENETICS & HEREDITY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: To evaluate cell-free fetal DNA fraction (cffDNAF) as a first-trimester screening marker for preeclampsia necessitating delivery before 37 weeks' gestation in twin pregnancies alone and combined with other bio-markers.

Methods: Women with two live fetuses were enrolled in the first trimester, and evaluated for cffDNAF as a first trimester preeclampsia marker alone, and with placental growth factor (PlGF), mean arterial pressure (MAP), and uterine artery pulsatility index (UtA-PI).

Results: There were 20 affected women; the cffDNAF was 9.0% (IQR: 8.4%-10.3%) in the affected, compared to 14% (IQR: 11%-16%) in 163 unaffected cases (p < 0.001). The AUROC for cffDNAF was 0.73 (95% CI: 0.61-0.85, p < 0.001), PlGF had an AUROC of 0.71 (0.59-0.83, p = 0.001), MAP had AUROC of 0.61 (0.50-0.72, p = 0.053) whereas UtA-PI had AUROC of 0.54 (0.39-0.69, p > 0.05). Combining all three biomarkers yielded an AUROC of 0.89 (0.78-0.98), with a sensitivity of 81%, specificity of 90%, negative predictive value (NPV) of 97.5%, and positive predictive value (PPV) of 50.7 UtA-PI did not contribute to the AUROC.

Conclusion: In twin pregnancies low first trimester cffDNAF effectively screens for preeclampsia necessitating delivery before 37 weeks' gestation, which is augmented with PlGF and MAP.

查看原文本刊更多论文

使用早期妊娠预测双胞胎子痫前期：cffDNA分数，PlGF和MAP。

目的：评价无细胞胎儿DNA分数（cffDNAF）作为双胎妊娠37周前需要分娩的子痫前期筛查标志物的单独和联合其他生物标志物。方法：在妊娠早期招募有两个活胎的妇女，将cffDNAF单独作为妊娠早期子痫前期标志物，并与胎盘生长因子（PlGF）、平均动脉压（MAP）和子宫动脉搏动指数（UtA-PI）一起进行评估。结果：患者20例；受影响患者的cffDNAF为9.0% (IQR: 8.4% ~ 10.3%)， 163例未受影响患者的cffDNAF为14% (IQR: 11% ~ 16%) （p 0.05）。联合使用这三种生物标志物的AUROC为0.89(0.78-0.98)，敏感性为81%，特异性为90%，阴性预测值（NPV）为97.5%，阳性预测值（PPV）为50.7，UtA-PI对AUROC没有贡献。结论：在低孕早期双胎妊娠中，cffDNAF可有效筛查妊娠37周前需要分娩的子痫前期，PlGF和MAP可增强该筛查效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Prenatal Diagnosis 医学-妇产科学

CiteScore

5.80

自引率

13.30%

发文量

204

审稿时长

2 months

期刊介绍： Prenatal Diagnosis welcomes submissions in all aspects of prenatal diagnosis with a particular focus on areas in which molecular biology and genetics interface with prenatal care and therapy, encompassing: all aspects of fetal imaging, including sonography and magnetic resonance imaging; prenatal cytogenetics, including molecular studies and array CGH; prenatal screening studies; fetal cells and cell-free nucleic acids in maternal blood and other fluids; preimplantation genetic diagnosis (PGD); prenatal diagnosis of single gene disorders, including metabolic disorders; fetal therapy; fetal and placental development and pathology; development and evaluation of laboratory services for prenatal diagnosis; psychosocial, legal, ethical and economic aspects of prenatal diagnosis; prenatal genetic counseling