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Prediction of small for gestational age infants in healthy nulliparous women using clinical and ultrasound risk factors combined with early pregnancy biomarkers
- Source :
- McCowan, L M E, Thompson, J M D, Taylor, R S, Baker, P N, North, R A, Poston, L, Roberts, C T, Simpson, N A B, Walker, J J, Myers, J, Kenny, L C, Healy, D, Briley, A, Murphy, N, Snapes, E, Chan, E & Black, M 2017, ' Prediction of small for gestational age infants in healthy nulliparous women using clinical and ultrasound risk factors combined with early pregnancy biomarkers ', PL o S One, vol. 12, no. 1, e0169311 . https://doi.org/10.1371/journal.pone.0169311, PLoS ONE, McCowan, L M E, Thompson, J M D, Taylor, R S, Baker, P N, North, R A, Poston, L, Roberts, C T, Simpson, N A B, Walker, J J, Myers, J, Kenny, L C & SCOPE consortium 2017, ' Prediction of Small for Gestational Age Infants in Healthy Nulliparous Women Using Clinical and Ultrasound Risk Factors Combined with Early Pregnancy Biomarkers ', PLoS ONE, vol. 12, no. 1, pp. e0169311 . https://doi.org/10.1371/journal.pone.0169311, PLoS ONE, Vol 12, Iss 1, p e0169311 (2017)
- Publication Year :
- 2017
-
Abstract
- OBJECTIVE: Most small for gestational age pregnancies are unrecognised before birth, resulting in substantial avoidable perinatal mortality and morbidity. Our objective was to develop multivariable prediction models for small for gestational age combining clinical risk factors and biomarkers at 15±1 weeks' with ultrasound parameters at 20±1 weeks' gestation.METHODS: Data from 5606 participants in the Screening for Pregnancy Endpoints (SCOPE) cohort study were divided into Training (n = 3735) and Validation datasets (n = 1871). The primary outcomes were All-SGA (small for gestational age with birthweight RESULTS: 633 (11.2%) infants were All-SGA, 465(8.2%) Normotensive-SGA and 168 (3%) Hypertensive-SGA. Area under the curve (95% Confidence Intervals) for All-SGA using 15±1 weeks' clinical variables, 15±1 weeks' clinical+ biomarker variables and clinical + biomarkers + biometry /Doppler at 20±1 weeks' were: 0.63 (0.59-0.67), 0.64 (0.60-0.68) and 0.69 (0.66-0.73) respectively in the Validation dataset; Normotensive-SGA results were similar: 0.61 (0.57-0.66), 0.61 (0.56-0.66) and 0.68 (0.64-0.73) with small increases in performance in the Training datasets. Area under the curve (95% Confidence Intervals) for Hypertensive-SGA were: 0.76 (0.70-0.82), 0.80 (0.75-0.86) and 0.84 (0.78-0.89) with minimal change in the Training datasets.CONCLUSION: Models for prediction of small for gestational age, which combine biomarkers, clinical and ultrasound data from a cohort of low-risk nulliparous women achieved modest performance. Incorporation of biomarkers into the models resulted in no improvement in performance of prediction of All-SGA and Normotensive-SGA but a small improvement in prediction of Hypertensive-SGA. Our models currently have insufficient reliability for application in clinical practice however, they have potential utility in two-staged screening tests which include third trimester biomarkers and or fetal biometry.
- Subjects :
- Physiology
Maternal Health
lcsh:Medicine
Early pregnancy factor
Blood Pressure
030204 cardiovascular system & hematology
Biochemistry
Vascular Medicine
Families
Placental Growth Factor
0302 clinical medicine
Endocrinology
Mathematical and Statistical Techniques
Pregnancy
Risk Factors
Placental growth factor
Medicine and Health Sciences
Medicine
Hypertensive disorders in pregnancy
lcsh:Science
Biological sciences
Children
030219 obstetrics & reproductive medicine
Multidisciplinary
biology
Scope (project management)
Pregnancy Outcome
Obstetrics and Gynecology
Prognosis
3. Good health
Parity
Hypertension
Physical Sciences
Infant, Small for Gestational Age
language
Female
Health board
Infants
Statistics (Mathematics)
Research Article
Pregnancy Trimester, Third
Library science
Gestational Age
Research and Analysis Methods
Ultrasonography, Prenatal
03 medical and health sciences
Irish
Hypertensive Disorders in Pregnancy
Growth Factors
Humans
Statistical Methods
National health
Government
Endocrine Physiology
business.industry
lcsh:R
Biology and Life Sciences
National health service
Preeclampsia
language.human_language
Pregnancy Complications
Age Groups
People and Places
biology.protein
Women's Health
lcsh:Q
Population Groupings
business
Biomarkers
Mathematics
Forecasting
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Database :
- OpenAIRE
- Journal :
- McCowan, L M E, Thompson, J M D, Taylor, R S, Baker, P N, North, R A, Poston, L, Roberts, C T, Simpson, N A B, Walker, J J, Myers, J, Kenny, L C, Healy, D, Briley, A, Murphy, N, Snapes, E, Chan, E & Black, M 2017, ' Prediction of small for gestational age infants in healthy nulliparous women using clinical and ultrasound risk factors combined with early pregnancy biomarkers ', PL o S One, vol. 12, no. 1, e0169311 . https://doi.org/10.1371/journal.pone.0169311, PLoS ONE, McCowan, L M E, Thompson, J M D, Taylor, R S, Baker, P N, North, R A, Poston, L, Roberts, C T, Simpson, N A B, Walker, J J, Myers, J, Kenny, L C & SCOPE consortium 2017, ' Prediction of Small for Gestational Age Infants in Healthy Nulliparous Women Using Clinical and Ultrasound Risk Factors Combined with Early Pregnancy Biomarkers ', PLoS ONE, vol. 12, no. 1, pp. e0169311 . https://doi.org/10.1371/journal.pone.0169311, PLoS ONE, Vol 12, Iss 1, p e0169311 (2017)
- Accession number :
- edsair.doi.dedup.....f07026a3d3a5effbab72cc7e218e4ce2