{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:58:08Z","timestamp":1786978688101,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003123","name":"Fetal Medicine Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003123","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet & Gyne"],"published-print":{"date-parts":[[2021,2]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n First, to validate a previously developed model for screening for pre\u2010eclampsia (PE) by maternal characteristics and medical history in twin pregnancies; second, to compare the distributions of mean arterial pressure (MAP), uterine artery pulsatility index (UtA\u2010PI), serum placental growth factor (PlGF) and serum pregnancy\u2010associated plasma protein\u2010A (PAPP\u2010A) in twin pregnancies that delivered with PE to those in singleton pregnancies and to develop new models based on these results; and, third, to examine the predictive performance of these models in screening for PE with delivery at <\u200932 and <\u200937\u2009weeks' gestation.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Two datasets of prospective non\u2010intervention multicenter screening studies for PE in twin pregnancies at 11\u2009+\u20090 to 13\u2009+\u20096\u2009weeks' gestation were used. The first dataset was from the EVENTS (Early vaginal progesterone for the preVention of spontaneous prEterm birth iN TwinS) trial and the second was from a previously reported study that examined the distributions of biomarkers in twin pregnancies. Maternal demographic characteristics and medical history from the EVENTS\u2010trial dataset were used to assess the validity of risks from our previously developed model. The combined data from the first and second datasets were used to compare the distributional properties of log\n 10<\/jats:sub>\n multiples of the median (MoM) values of UtA\u2010PI, MAP, PlGF and PAPP\u2010A in twin pregnancies that delivered with PE to those in singleton pregnancies and develop new models based on these results. The competing\u2010risks model was used to estimate the individual patient\u2010specific risks of delivery with PE at <\u200932 and <\u200937\u2009weeks' gestation. Screening performance was measured by detection rates (DR) and areas under the receiver\u2010operating\u2010characteristics curve.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The EVENTS\u2010trial dataset comprised 1798 pregnancies, including 168 (9.3%) that developed PE. In the validation of the prior model based on maternal characteristics and medical history, calibration plots demonstrated very good agreement between the predicted risks and the observed incidence of PE (calibration slope and intercept for PE <\u200932\u2009weeks were 0.827 and 0.009, respectively, and for PE <\u200937\u2009weeks they were 0.942 and \u22120.207, respectively). In the combined data, there were 3938 pregnancies, including 339 (8.6%) that developed PE and 253 (6.4%) that delivered with PE at <\u200937\u2009weeks' gestation. In twin pregnancies that delivered with PE, MAP, UtA\u2010PI and PlGF were, at earlier gestational ages, more discriminative than in singleton pregnancies and at later gestational ages they were less so. For PAPP\u2010A, there was little difference between PE and unaffected pregnancies. The best performance of screening for PE was achieved by a combination of maternal factors, MAP, UtA\u2010PI and PlGF. In screening by maternal factors alone, the DR, at a 10% false\u2010positive rate, was 30.6% for delivery with PE at <\u200932\u2009weeks' gestation and this increased to 86.4% when screening by the combined test; the respective values for PE <\u200937\u2009weeks were 24.9% and 41.1%.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In the assessment of risk for PE in twin pregnancy, we can use the same prior model based on maternal characteristics and medical history as reported previously, but in the calculation of posterior risks it is necessary to use the new distributions of log\n 10<\/jats:sub>\n MoM values of UtA\u2010PI, MAP and PlGF according to gestational age at delivery with PE. \u00a9 2020 International Society of Ultrasound in Obstetrics and Gynecology\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/uog.23531","type":"journal-article","created":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T18:44:04Z","timestamp":1604429044000},"page":"257-265","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Prediction of pre\u2010eclampsia in twin pregnancy by maternal factors and biomarkers at 11\u201313\u2009weeks' gestation: data from\n EVENTS<\/scp>\n trial"],"prefix":"10.1002","volume":"57","author":[{"given":"Z.","family":"Benk\u0151","sequence":"first","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Wright","sequence":"additional","affiliation":[{"name":"University of Exeter Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Rehal","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Cimpoca","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5856-6072","authenticated-orcid":false,"given":"A.","family":"Syngelaki","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. L.","family":"Delgado","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario Virgen de la Arrixaca and Institute for Biomedical Research of Murcia, IMIB\u2010Arrixaca Murcia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Tsokaki","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital London UK"},{"name":"North Middlesex University Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"De Alvarado","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital London UK"},{"name":"Homerton University Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Vojtassakova","sequence":"additional","affiliation":[{"name":"Medway Maritime Hospital, Gillingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Malligiannis Ntalianis","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital London UK"},{"name":"Southend University Hospital Westcliff\u2010on\u2010Sea UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Chaveeva","sequence":"additional","affiliation":[{"name":"Dr. Shterev Hospital Sofia Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Del Campo","sequence":"additional","affiliation":[{"name":"Hospital Universitario Cruces Biocruces Bizkaia Health Research Institute, UPV\/EHU Bizkaia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"De Ganzo","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital London UK"},{"name":"Hospital Universitario San Cecilio Instituto de Investigaci\u00f3n Biosanitaria (IBS) Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Resta","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital London UK"},{"name":"Chelsea and Westminster Hospital Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Atanasova","sequence":"additional","affiliation":[{"name":"Hospital Universitario La Paz Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Accurti","sequence":"additional","affiliation":[{"name":"Ospedale Maggiore Policlinico, Milan and Department of Clinical Sciences and Community Health University of Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Villalain","sequence":"additional","affiliation":[{"name":"Hospital Universitario \u201c12 De Octubre\u201d, Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Aguilera","sequence":"additional","affiliation":[{"name":"University Hospital Lewisham London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Dojcinovska","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital London UK"},{"name":"Royal London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"O'Gorman","sequence":"additional","affiliation":[{"name":"Hospital Necker Enfants Malades Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Plasencia","sequence":"additional","affiliation":[{"name":"Hospiten Group Tenerife Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Zingler","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital London UK"},{"name":"Kingston Hospital Kingston upon Thames UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Dutemeyer","sequence":"additional","affiliation":[{"name":"University Hospital Brugmann Universit\u00e9 Libre de Bruxelles Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Alvar","sequence":"additional","affiliation":[{"name":"University Hospital A Coru\u00f1a Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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