Screening for preeclampsia in the first trimester of pregnancy in routine clinical practice in Hungary

Laszlo Orosz, Gergo Orosz, Lajos Veress, Diana Dosa, Laszlo Orosz, Ibolya Arany, Antal Fabian, Laszlo Medve, Karoly Pap, Z. Karányi, Zoltan Toth, Robert Poka, Nandor Gabor Than, Olga Torok

Research output: Article

Abstract

We aimed to evaluate the contribution of different factors in the Fetal Medicine Foundation algorithms for preeclampsia (PE) risk calculation during first-trimester screening in Hungary. We selected subjects for the nested case-control study from a prospective cohort of 2545 low-risk pregnancies. Eighty-two patients with PE and 82 gestational age-matched controls were included. Individual PE risk was calculated using two risk-assessing softwares. Using Astraia 2.3.1, considering maternal characteristics and biophysical parameters only, detection rates (DR) were 63.6% for early-PE and 67.6% for late-PE. When we added placenta associated plasma protein A (PAPP-A) to the risk calculation, DRs decreased to 54.5% and 64.8% respectively. Using Astraia 2.8.2 with maternal characteristics and biophysical parameters resulted in the DRs of 63.6% (early-PE) and 56.3% (late-PE). If we added PAPP-A to the risk calculation, DRs improved to 72.7% and 54.9%. The addition of placental growth factor (PlGF) did not increase detection rates in either calculation. In conclusion, using maternal characteristics, biophysical parameters, and PAPP-A, an acceptable screening efficacy could be achieved for early-PE during first-trimester screening. Since PlGF did not improve efficacy in our study, we suggest setting new standard curves for PlGF in Eastern European pregnant women, and the evaluation of novel biochemical markers.

Original languageEnglish
Pages (from-to)11-19
Number of pages9
JournalJournal of Biotechnology
Volume300
DOIs
Publication statusPublished - júl. 20 2019

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Hungary
First Pregnancy Trimester
Pre-Eclampsia
Screening
Staphylococcal Protein A
Blood Proteins
Intercellular Signaling Peptides and Proteins
Placenta
Proteins
Plasmas
Mothers
Medicine
Gestational Age
Case-Control Studies
Pregnant Women
Software
Biomarkers
Pregnancy

ASJC Scopus subject areas

  • Biotechnology
  • Bioengineering
  • Applied Microbiology and Biotechnology

Cite this

Screening for preeclampsia in the first trimester of pregnancy in routine clinical practice in Hungary. / Orosz, Laszlo; Orosz, Gergo; Veress, Lajos; Dosa, Diana; Orosz, Laszlo; Arany, Ibolya; Fabian, Antal; Medve, Laszlo; Pap, Karoly; Karányi, Z.; Toth, Zoltan; Poka, Robert; Than, Nandor Gabor; Torok, Olga.

In: Journal of Biotechnology, Vol. 300, 20.07.2019, p. 11-19.

Research output: Article

Orosz, L, Orosz, G, Veress, L, Dosa, D, Orosz, L, Arany, I, Fabian, A, Medve, L, Pap, K, Karányi, Z, Toth, Z, Poka, R, Than, NG & Torok, O 2019, 'Screening for preeclampsia in the first trimester of pregnancy in routine clinical practice in Hungary', Journal of Biotechnology, vol. 300, pp. 11-19. https://doi.org/10.1016/j.jbiotec.2019.04.017
Orosz, Laszlo ; Orosz, Gergo ; Veress, Lajos ; Dosa, Diana ; Orosz, Laszlo ; Arany, Ibolya ; Fabian, Antal ; Medve, Laszlo ; Pap, Karoly ; Karányi, Z. ; Toth, Zoltan ; Poka, Robert ; Than, Nandor Gabor ; Torok, Olga. / Screening for preeclampsia in the first trimester of pregnancy in routine clinical practice in Hungary. In: Journal of Biotechnology. 2019 ; Vol. 300. pp. 11-19.
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AU - Dosa, Diana

AU - Orosz, Laszlo

AU - Arany, Ibolya

AU - Fabian, Antal

AU - Medve, Laszlo

AU - Pap, Karoly

AU - Karányi, Z.

AU - Toth, Zoltan

AU - Poka, Robert

AU - Than, Nandor Gabor

AU - Torok, Olga

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AB - We aimed to evaluate the contribution of different factors in the Fetal Medicine Foundation algorithms for preeclampsia (PE) risk calculation during first-trimester screening in Hungary. We selected subjects for the nested case-control study from a prospective cohort of 2545 low-risk pregnancies. Eighty-two patients with PE and 82 gestational age-matched controls were included. Individual PE risk was calculated using two risk-assessing softwares. Using Astraia 2.3.1, considering maternal characteristics and biophysical parameters only, detection rates (DR) were 63.6% for early-PE and 67.6% for late-PE. When we added placenta associated plasma protein A (PAPP-A) to the risk calculation, DRs decreased to 54.5% and 64.8% respectively. Using Astraia 2.8.2 with maternal characteristics and biophysical parameters resulted in the DRs of 63.6% (early-PE) and 56.3% (late-PE). If we added PAPP-A to the risk calculation, DRs improved to 72.7% and 54.9%. The addition of placental growth factor (PlGF) did not increase detection rates in either calculation. In conclusion, using maternal characteristics, biophysical parameters, and PAPP-A, an acceptable screening efficacy could be achieved for early-PE during first-trimester screening. Since PlGF did not improve efficacy in our study, we suggest setting new standard curves for PlGF in Eastern European pregnant women, and the evaluation of novel biochemical markers.

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KW - Placental growth factor

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KW - Screening

KW - Uterine artery Doppler

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