scholarly journals Mean arterial pressure for predicting preeclampsia in Asian women: a longitudinal cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046161
Author(s):  
Jing Zhu ◽  
Jun Zhang ◽  
Nurul Syaza Razali ◽  
Bernard Chern ◽  
Kok Hian Tan

ObjectivePrevious studies suggested mean arterial pressure (MAP) had moderate predictive values in the first and second trimesters for the prediction of preeclampsia. However, the performance of MAP in Asian women is still unclear. The objective of this study was to examine the predictive values of MAP in Asian population throughout gestation, and to compare the performance of MAP, angiogenic factors and uterine artery Doppler in the prediction of preeclampsia.DesignA prospective cohort study.SettingKK Women’s and Children’s Hospital, Singapore.ParticipantsA total of 926 women with singleton pregnancy less than 14 weeks of gestation were included in the prospective Neonatal and Obstetrics Risks Assessment cohort between September 2010 and October 2014. Maternal blood pressure levels, uterine artery pulsatility index (UtA-PI), serum soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF) and sFlt-1/PlGF ratio were measured at 11–14, 18–22, 28–32 and 34 weeks onward, respectively.Primary and secondary outcomesPreeclampsia was the main pregnancy outcome.ResultsA total of 20 women developed preeclampsia, who had significantly lower levels of PlGF, higher levels of sFlt-1/PlGF ratio and MAP throughout pregnancy than women without preeclampsia. Compared with angiogenic factors and UtA-PI, MAP had significantly higher area under the receiver operating characteristic curves (AUCs) for predicting preeclampsia and term preeclampsia throughout gestation. For predicting preeclampsia, MAP had AUCs of 0.86 (95% CI 0.78 to 0.95), 0.87 (95% CI 0.80 to 0.95) and 0.91 (95% CI 0.85 to 0.98) at 11–14, 18–22 and 28–32 weeks, respectively. For predicting term preeclampsia, MAP yielded AUCs of 0.87 (95% CI 0.75 to 0.99), 0.87 (95% CI 0.76 to 0.98) and 0.90 (95% CI 0.80 to 0.99) at 11–14, 18–22 and 28–32 weeks, respectively. For predicting preterm preeclampsia, the performance of MAP and PlGF was similar.ConclusionMAP is a good predictor for preeclampsia, especially term preeclampsia, in Asian women.

2018 ◽  
Vol 6 (3) ◽  
pp. 57
Author(s):  
Urjindelger Tserensambuu ◽  
Ariunbold Chuluun-Erdene ◽  
Munkhtsetseg Janlav ◽  
Erkhembaatar Tudevdorj

Preeclampsia (PE) is a major cause of maternal and perinatal morbidity and mortality, particularly in developing countries. In Mongolia, preeclampsia and eclampsia have occurred among pregnancy complications at a rate of 25% in recent years. Recent studies in the literature have screened for preeclampsia by combining maternal factors with biomarkers. This study was conducted using prospective cohort research including 393 singleton pregnancies at 11–13+6 weeks. Maternal plasmas pregnancy-associated plasma protein-A (PAPP-A) and maternal serum placental growth factor (PlGF) were measured using Perkin Elmer time-resolved fluoroimmunoassay (DELFIA) kits, and the measurement of mean arterial pressure (MAP) was performed by automated devices and the uterine artery pulsatility index was measured by Doppler ultrasound. In the study population, there were 16.7% showing complicated preeclampsia. The receiver-operating characteristics (ROC) curve analysis showed a sensitivity of 71.21%, and a specificity of 75.54% when the mean arterial pressure cut-off was 89.5 mm; while a sensitivity of 33.36% and specificity of 77.68% were observed when the uterine artery mean pulsatility index (mPI) cut-off was 2.34; a sensitivity of 79.66% and specificity of 44.04% were observed when the PAPP-A cut-off was 529.1 mU/L; and a sensitivity of 74.58% and specificity of 46.6% were observed when the PlGF cut-off was 39.87 pg/mL. The detection rates following the combination of markers with the maternal history were as follows: 62.7% with mean arterial pressure, 69.5–82.9% with two markers 86.5% with three markers and 91.4% with four markers. In conclusion, the mean arterial pressure was highly sensitive and demonstrated its easy usage and cost-effectiveness as a predictive marker for the early screening of preeclampsia from other biomarkers.


2008 ◽  
Vol 32 (7) ◽  
pp. 877-883 ◽  
Author(s):  
N. Onwudiwe ◽  
C. K. H. Yu ◽  
L. C. Y. Poon ◽  
I. Spiliopoulos ◽  
K. H. Nicolaides

Critical Care ◽  
2011 ◽  
Vol 15 (3) ◽  
pp. R135 ◽  
Author(s):  
Julie Badin ◽  
Thierry Boulain ◽  
Stephan Ehrmann ◽  
Marie Skarzynski ◽  
Anne Bretagnol ◽  
...  

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