使用胎儿医学基金会的算法来确定巴西人群中子痫前期预测的截止点。

IF 1.6 Q3 OBSTETRICS & GYNECOLOGY
Minerva obstetrics and gynecology Pub Date : 2023-12-01 Epub Date: 2022-06-22 DOI:10.23736/S2724-606X.22.05061-8
Joana A Andrade, Antonio B Viana Junior, Sammya B Holanda Moura, Julio A Gurgel Alves, Edward Araujo Júnior, Francisco H Carvalho
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引用次数: 0

摘要

背景:利用胎儿医学基金会(FMF)的算法确定巴西人群中子痫前期(PE)预测的截止点。方法:对274例胎龄11 ~ 13周6天的未生育患者进行随机临床试验。为了计算PE的风险,使用了FMF网站(http://fetalmedicine.org/research/assess/preeclampsia/first-trimester)上提供的算法。其中138例患者未采取预防措施(100mg /天阿司匹林[ASA])。约登标准用于计算截止点。为了测试100mg /d ASA预防PE的有效性,将患者分为两组,风险高于和低于临界值。结果:135例未服用ASA的患者中位年龄为22岁,体重指数(BMI)为59.3 kg/m2,平均动脉压(MAP)为73.3 mmHg,平均子宫动脉多普勒脉搏指数为1.71。分娩时中位胎龄为39.3(38.1-40.3)周。PE患病率为11.1%。在我们的样本中,使用100毫克/天的ASA使总PE降低了36.3%(当使用ASA和安慰剂时,高于临界值的组PE患病率分别为19%和12.1%)。结论:预测PE的截止点为1:155,敏感性为80%,特异性为57.5%,阳性预测值为19.1%,阴性预测值为95%,这有助于选择受益于预防性ASA的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Using the algorithm of the Fetal Medicine Foundation to determine the cutoff point for prediction of pre-eclampsia in a Brazilian population.

Background: To use the algorithm of the Fetal Medicine Foundation (FMF) to determine the cutoff point for prediction of preeclampsia (PE) in a Brazilian population.

Methods: Randomized clinical trial with 274 nulliparous patients at gestational age between 11 and 13 weeks and 6 days. To calculate the risk of PE, the algorithm available at the website of the FMF (http://fetalmedicine.org/research/assess/preeclampsia/first-trimester) was used. Among the patients, 138 did not use preventive measures (100 mg/day aspirin [ASA]). Youden's criteria were used to calculate the cutoff point. To test the effectiveness of 100 mg/day ASA in preventing PE, the patients were divided into two groups - at risk above and below the cutoff point.

Results: In the group comprising the 135 patients that did not take ASA, the median age was 22 years, the Body Mass Index (BMI) was 59.3 kg/m2, the mean arterial pressure (MAP) was 73.3 mmHg, and the mean pulsatility index of uterine artery Doppler was 1.71. The median gestational age at delivery was 39.3 (38.1-40.3) weeks. The prevalence of PE was 11.1%. In our sample, the use of 100 mg/day ASA reduced total PE by 36.3% (prevalence of PE in the group above the cutoff point was 19% and 12.1% when ASA and placebo were used, respectively).

Conclusions: The cutoff point defined for prediction of PE was 1:155 with sensitivity of 80%, specificity of 57.5%, positive predictive value of 19.1%, and negative predictive value of 95%, which should help to select patients that will benefit from prophylactic ASA.

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来源期刊
Minerva obstetrics and gynecology
Minerva obstetrics and gynecology OBSTETRICS & GYNECOLOGY-
CiteScore
2.90
自引率
11.10%
发文量
191
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