Ran Svirsky, Adi Sharabi-Nov, Ron Maymon, Nadav Kugler, Moran Landau Rabbi, Richard Brown, Heidy Portillo Rodriguez, Linda Peltier, Kypros Nicolaides, Hamutal Meiri
{"title":"使用早期妊娠预测双胞胎子痫前期：cffDNA分数，PlGF和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":"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>In twin pregnancies low first trimester cffDNAF effectively screens for preeclampsia necessitating delivery before 37 weeks' gestation, which is augmented with PlGF and MAP.</p>","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":"{\"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\":\"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>In twin pregnancies low first trimester cffDNAF effectively screens for preeclampsia necessitating delivery before 37 weeks' gestation, which is augmented with PlGF and MAP.</p>\",\"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}","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}
Prediction of Preeclampsia in Twins Using First Trimester: cffDNA Fraction, PlGF, and MAP.
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.
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
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