{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T21:17:27Z","timestamp":1774905447903,"version":"3.50.1"},"reference-count":47,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate cell\u2010free fetal DNA fraction (cffDNAF) as a first\u2010trimester screening marker for preeclampsia necessitating delivery before 37\u00a0weeks' gestation in twin pregnancies alone and combined with other bio\u2010markers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women with two live fetuses were enrolled in the first trimester, and evaluated for cffDNAF as a first trimester preeclampsia marker alone, and with placental growth factor (PlGF), mean arterial pressure (MAP), and uterine artery pulsatility index (UtA\u2010PI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 20 affected women; the cffDNAF was 9.0% (IQR: 8.4%\u201310.3%) in the affected, compared to 14% (IQR: 11%\u201316%) in 163 unaffected cases (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). The AUROC for cffDNAF was 0.73 (95% CI: 0.61\u20130.85, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), PlGF had an AUROC of 0.71 (0.59\u20130.83, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001), MAP had AUROC of 0.61 (0.50\u20130.72, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.053) whereas UtA\u2010PI had AUROC of 0.54 (0.39\u20130.69, <jats:italic>p<\/jats:italic>\u00a0&gt;\u00a00.05). Combining all three biomarkers yielded an AUROC of 0.89 (0.78\u20130.98), with a sensitivity of 81%, specificity of 90%, negative predictive value (NPV) of 97.5%, and positive predictive value (PPV) of 50.7 UtA\u2010PI did not contribute to the AUROC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In twin pregnancies low first trimester cffDNAF effectively screens for preeclampsia necessitating delivery before 37\u00a0weeks' gestation, which is augmented with PlGF and MAP.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6820","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T10:33:30Z","timestamp":1747823610000},"page":"968-978","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Prediction of Preeclampsia in Twins Using First Trimester: cffDNA Fraction, PlGF, and 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Obstetrics and Gynecology Shamir (Assaf Harofeh) Medical Center  Zerifin Israel"},{"name":"Faculty of Medicine and Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadav","family":"Kugler","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Shamir (Assaf Harofeh) Medical Center  Zerifin Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moran","family":"Landau Rabbi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Shamir (Assaf Harofeh) Medical Center  Zerifin Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5476-2698","authenticated-orcid":false,"given":"Richard","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine Department of Obstetrics and Gynecology McGill University Health Centre McGill University  Montreal 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