Maternal Serum EG-VEGF as A First Trimester Predictor of Hypertensive Disorders of Pregnancy: A Prospective Cohort Study

2021 ◽  
Author(s):  
Shiyu Zeng ◽  
Ling Yu ◽  
Yiling Ding ◽  
Mengyuan Yang
Keyword(s):  
Cohort Study ◽  
Growth Factor ◽  
Prediction Model ◽  
Pregnant Women ◽  
Predictive Value ◽  
Prospective Cohort ◽  
First Trimester ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Sensitivity Specificity

Abstract Background This study aims to explore whether plasma endocrine gland-derived vascular endothelial growth factor (EG-VEGF) in the first trimester can be used as a predictor of hypertensive disorders of pregnancy (HDP), and compare it with placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) to evaluate its prediction of HDP value. Methods This is a prospective cohort study that records the medical history of the pregnant women included in the study at 11–13 weeks’ gestation, and analyzes serum biochemical markers including EG-VEGF, PIGF, sFlt-1 and sFlt-1/PIGF. The predictive values of these tests were determined. We used the receiver operating characteristic (ROC) curve to find the optimal cut-off value for each biomarker and compare the operating characteristics (sensitivity, specificity). Logistic regression analysis was used to create a prediction model for HDP based on maternal characteristics and maternal biochemistry. Results Data were obtained from 205 pregnant women. 17 cases were diagnosed with HDP, the incidence rate was 8.2% (17/205). Women who developed HDP had a significantly higher body mass index (BMI) and mean arterial pressure (MAP). Serum EG-VEGF levels in the first trimester are significantly higher in pregnant women with HDP. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value(NPV) of serum EG-VEGF levels more than 227.83 pg/ml for predicting HDP were 43%, 93%, 86% and 62%, respectively. We established a prediction model in the first trimester include maternal BMI, MAP, and EG-VEGF, with an AUC of 0.8861 (95%CI: 0.7905–0.9818), which is better than using EG-VEGF alone (AUC: 0.66). Conclusion This study demonstrated that serum EG-VEGF is a promising biomarker for predicting HDP in the first trimester. It has better predictive performance compared with the currently used biomarkers like PIGF and sFlt-1. Combining maternal clinical characteristics and biochemical tests at 11–13 weeks can effectively identify women at high risk of HDP.

Antenatal Detection of Abnormal Placental Cord Insertion across Different Trimesters: A Prospective Cohort Study

2019 ◽  
Vol 37 (01) ◽  
pp. 104-111
Author(s):  
Khadijah I. Ismail ◽  
Ailish Hannigan ◽  
Peter Kelehan ◽  
Keelin O'Donoghue ◽  
Amanda Cotter
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Predictive Value ◽  
Prospective Cohort ◽  
First Trimester ◽  
Third Trimester ◽  
Shortest Distance ◽  
Tertiary Center ◽  
Antenatal Detection ◽  
Sensitivity Specificity

Abstract Objectives This article prospectively examines the use of ultrasound for antenatal detection of abnormal placental cord insertion (PCI) and compares the antenatal classification with delivered placental classification. Study Design This prospective cohort study examined 277 singleton pregnancies in a tertiary center. Scans were performed between 10 and 14, 18 and 22, and 32 and 34 weeks where PCI site was identified and its shortest distance to margin measured. Standardized images of delivered placentas were taken and digitally measured. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of antenatal classification compared with delivered placental classification were calculated. Results Abnormal PCI (distance < 2 cm from margin) was confirmed in 30/277 (11%) placentas at delivery. Note that 102/277 (37%) of PCI sites were classified as abnormal in the first trimester (T1), 43/277 (16%) in the second trimester (T2), and 28/277 (10%) in the third trimester (T3). Sensitivity (73%) and specificity (91%) were highest at T2. The PPVs were low (22% in T1, 51% in T2, and 64% in T3) and the NPVs were high (96% in T1 and 97% in both T2 and T3) for all scans. Conclusion Abnormal PCI can be detected antenatally with optimal agreement with postnatal classification in T2. However, the incidence is overestimated at early scans with low PPVs.

scholarly journals NIPT Technique Based on the Use of Long Chimeric DNA Reads

Genes ◽  
2020 ◽  
Vol 11 (6) ◽  
pp. 590
Author(s):  
Vera Belova ◽  
Daria Plakhina ◽  
Sergey Evfratov ◽  
Kirill Tsukanov ◽  
Gennady Khvorykh ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Predictive Value ◽  
High Performance ◽  
High Throughput Sequencing ◽  
Prenatal Testing ◽  
First Trimester ◽  
Extracellular Dna ◽  
Trimester Screening ◽  
Sensitivity Specificity ◽  
Analytical Approaches

Non-invasive prenatal testing (NIPT) for aneuploidy on Chromosomes 21 (T21), 18 (T18) and 13 (T13) is actively used in clinical practice around the world. One of the limitations of the wider implementation of this test is the high cost of the analysis itself, as high-throughput sequencing is still relatively expensive. At the same time, there is an increasing trend in the length of reads yielded by sequencers. Since extracellular DNA is short, in the order of 140–160 bp, it is not possible to effectively use long reads. The authors used high-performance sequencing of cell-free DNA (cfDNA) libraries that went through additional stages of enzymatic fragmentation and random ligation of the resulting products to create long chimeric reads. The authors used a controlled set of samples to analyze a set of cfDNA samples from pregnant women with a high risk of fetus aneuploidy according to the results of the first trimester screening and confirmed by invasive karyotyping of the fetus using laboratory and analytical approaches developed by the authors. They evaluated the sensitivity, specificity, PPV (positive predictive value), and NPV (negative predictive value) of the results. The authors developed a technique for constructing long chimeric reads from short cfDNA fragments and validated the test using a control set of extracellular DNA samples obtained from pregnant women. The obtained sensitivity and specificity parameters of the NIPT developed by the authors corresponded to the approaches proposed earlier (99.93% and 99.14% for T21; 100% and 98.34% for T18; 100% and 99.17% for T13, respectively).

scholarly journals Cardiac dysfunction and remodeling regulated by anti-angiogenic environment in patients with preeclampsia: the ANGIOCOR prospective cohort study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Johana Ullmo ◽  
Monica Cruz-Lemini ◽  
Olga Sánchez-García ◽  
Lidia Bos-Real ◽  
Patricia Fernandez De La Llama ◽  
...  
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
Cardiac Function ◽  
Pregnant Women ◽  
Prospective Cohort Study ◽  
Cardiac Dysfunction ◽  
Prospective Cohort ◽  
First Trimester ◽  
Cardiac Biomarkers ◽  
Cvd Risk

Abstract Background Cardiovascular diseases (CVD) are cause of increased morbidity and mortality in spite of advances for diagnosis and treatment. Changes during pregnancy affect importantly the maternal CV system. Pregnant women that develop preeclampsia (PE) have higher risk (up to 4 times) of clinical CVD in the short- and long-term. Predominance of an anti-angiogenic environment during pregnancy is known as main cause of PE, but its relationship with CV complications is still under research. We hypothesize that angiogenic factors are associated to maternal cardiac dysfunction/remodeling and that these may be detected by new cardiac biomarkers and maternal echocardiography. Methods Prospective cohort study of pregnant women with high-risk of PE in first trimester screening, established diagnosis of PE during gestation, and healthy pregnant women (total intended sample size n = 440). Placental biochemical and biophysical cardiovascular markers will be assessed in the first and third trimesters of pregnancy, along with maternal echocardiographic parameters. Fetal cardiac function at third trimester of pregnancy will be also evaluated and correlated with maternal variables. Maternal cardiac function assessment will be determined 12 months after delivery, and correlation with CV and PE risk variables obtained during pregnancy will be evaluated. Discussion The study will contribute to characterize the relationship between anti-angiogenic environment and maternal CV dysfunction/remodeling, during and after pregnancy, as well as its impact on future CVD risk in patients with PE. The ultimate goal is to improve CV health of women with high-risk or previous PE, and thus, reduce the burden of the disease. Trial registration NCT04162236

scholarly journals Red Blood Cells in The First Trimester and The Risk of Gestational Diabetes: A Prospective Cohort Study

2021 ◽  
Author(s):  
Jiajing Jia ◽  
Ying Yang ◽  
Minjin Zhang ◽  
Li Lin ◽  
Yequn Chen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Gestational Diabetes ◽  
Blood Cell ◽  
Pregnant Women ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Hematological Parameters ◽  
First Trimester ◽  
Logistic Regression Models ◽  
Increased Risk

Abstract Background: This research aimed to assess the potential association of gestational diabetes (GDM) with early trimester hematological parameters including hemoglobin (Hb), red blood cell (RBC), white blood cell (WBC), and platelet count (PLT) through a prospective cohort study.Methods: The prospective cohort included pregnant women subjected to prenatal examination at Shantou and Beijing hospitals in China from March 2014 to December 2015. Data were collected since the first perinatal visit in obstetrics clinics, and then participants were followed up at 24, 32, 36 gestational weeks and the time of delivery, respectively. Multivariable adjusted logistic regression models were conducted to estimate odds ratio (OR) and its corresponding 95% confidence interval (95% CI).Results: A total of 1004 pregnant women with singletons, less than 12 gestational weeks, and without history of chronic disease were eligible for analysis. The incidence of GDM was 18.82%, and the mean age was 29.50 ± 3.84 years. Total of 187 (18.63%) women who had abnormal RBC level and 222 (22.11%) had abnormal Hb in the first trimester of pregnancy. After multivariable adjustment, each unit increment in numeric RBC or Hb was associated with 177% and 4% increased risk for GDM. The risk for GDM was significantly increased with higher RBC (OR: 2.00 for RBC>4.55×1012 /L) and Hb (OR: 2.14 for Hb>139 g/L) levels in the first trimester.Conclusions: Elevated RBC and Hb in the first trimester are associated with increasing risk of GDM. Further evidence are warranted to confirm these possible causal relationships.

scholarly journals Utility of second trimester beta HCG levels in prediction of gestational hypertension: a prospective cohort study

2017 ◽  
Vol 6 (3) ◽  
pp. 1040
Author(s):  
Heena Chowdhary ◽  
Rabia Khurshid ◽  
Shameema Parveen ◽  
Shagufta Yousuf ◽  
Showkat Hussain Tali ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Predictive Value ◽  
Gestational Hypertension ◽  
Beta Hcg ◽  
Observational Cohort ◽  
Β Hcg ◽  
Sensitivity Specificity ◽  
High Beta

Background: Gestational hypertension is a significant threat both to maternal and fetal health. However, it is still a distant dream to predict accurately its occurrence in early pregnancy. Objective was to find out if β HCG levels determined between 13 to 20 weeks of gestation can be used as a predictor for gestational hypertension.Methods: This prospective observational cohort study was conducted from August 2014 to January 2016. Serum β HCG levels were determined at 13 to 20 weeks of gestation of 190 normotensive pregnant women attending the antenatal clinics. They were followed for the development of gestational hypertension till 40 weeks of gestation or delivery.Results: Out of the total 190 women, 25 (13.1%) developed gestation hypertension. Of those who developed gestational hypertension, 22 (88%) were having β HCG levels >2 MOM (p<0.001). Absolute β HCG levels (Mean±SD) were also significantly higher (54907±29509 V/S 41095±19103; p<0.001) in subjects who later developed gestational hypertension. Sensitivity, specificity, positive predictive value and the negative predictive value for β HCG at >2 MOM were 83.3, 96.9, 80.0 and 97.5 respectively (95% CI).Conclusions: Pregnant women with high Beta HCG levels in early pregnancy have significantly higher risk for development of gestational hypertension.

scholarly journals Hypertensive disorders of pregnancy and cognitive impairment: A prospective cohort study

Neurology ◽  
2020 ◽  
pp. 10.1212/WNL.0000000000011363
Author(s):  
Maria C ADANK ◽  
Rowina F HUSSAINALI ◽  
Lise C OOSTERVEER ◽  
M Arfan IKRAM ◽  
Eric AP STEEGERS ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cognitive Impairment ◽  
Cognitive Performance ◽  
Prospective Cohort ◽  
Hypertensive Disorders Of Pregnancy ◽  
G Factor ◽  
Hypertensive Disorders ◽  
History Of ◽  
Learning Test ◽  
Normotensive Pregnancy

Objective:To determine the association between hypertensive disorders of pregnancy (HDP) and cognitive impairment fifteen years after pregnancy, we measured cognitive performance in 115 women with a history of HDP and in 481 women with a previous normotensive pregnancy.Methods:This was a nested cohort study embedded in a population-based prospective cohort from early pregnancy onwards. Cognitive function was assessed with cognitive tests fifteen years after the index pregnancy (median 14.7 years, 90% range [13.9 to 16.1]). Cognitive performance was measured in different cognitive domains: executive function, processing speed, verbal memory, motor function, and visuospatial ability. A global cognition factor (g-factor) was derived from principal component analysis.Results:Of the women with HDP, n = 80 (69.6%) had gestational hypertension (GH) and n = 35 (30.4%) had pre-eclampsia. Women with HDP had a lower g-factor than women with a previous normotensive pregnancy (mean difference -0.22, 90% range [-2.06; 1.29)]). HDP was negatively associated with the 15-word learning test: immediate recall (-0.25, 95% CI [-0.44 to -0.06]) and delayed recall (-0.30, 95% CI [-0.50 to -0.10]). Women with GH perform significantly worse on their 15-word learning test than women with a previous normotensive pregnancy.Conclusion:A history of HDP is independently associated with poorer working memory and verbal learning, fifteen years after pregnancy. This association is mainly driven by women with GH. Clinicians and women who experienced HDP should be aware of this risk.

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