ABSTRACT
Objective: To compare the predictive accuracy of the Gaussian
and Fetal Medicine Foundation (FMF) algorithms for preeclampsia (PE) and
small for gestational age fetuses (SGA).
Design: Secondary analysis of a prospective cohort study.
Setting: Tertiary referral hospital.
Population: 2,641 singleton pregnancies attending routine
first-trimester scan from October 2015 to September 2017.
Methods: Maternal characteristics, mean arterial blood
pressure, and mean uterine artery pulsatility index were recorded at the
first-trimester scan. Serum placental growth factor and
pregnancy-associated plasma protein-A were assessed between 8+0 and 13+6
weeks of gestation.
Main outcome measures: The areas under the curve for the
predictive performance for early-onset (delivery <34 weeks)
and preterm (delivery <37 weeks) PE, and early-onset (delivery
<32 weeks) and preterm (delivery <37 weeks) SGA,
were calculated with the Gaussian and FMF algorithms, and were
subsequently compared.
Results: Among the 2,641 participants, 30 (1.14%) developed
preterm PE, including 11 (0.42%) early-onset PE. Among the 2483
newborns, 44 (1.77%) were preterm SGA, including eight (0.32%)
early-onset SGA. The FMF and the Gaussian algorithm showed a similar
predictive performance for most outcomes and marker combinations.
Conclusions: This study shows that the first-trimester Gaussian
and FMF algorithms have similar performances for PE and SGA prediction.
Accuracy of the FMF algorithm was similar to that reported in the
original studies, adding evidence to its external validity.
Funding: none
Keywords: preeclampsia, screening, PlGF, early-onset
preeclampsia, uterine artery Doppler, first trimester
Tweetable abstract: The first-trimester Gaussian and FMF
algorithms have similar predictive performances for preeclampsia and
small-for-gestational-age fetuses.