{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:12:49Z","timestamp":1792080769785,"version":"4.4.0"},"reference-count":57,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate, in a Chinese population, the performance of a screening strategy for preterm pre\u2010eclampsia (PE) using The Fetal Medicine Foundation (FMF)'s competing\u2010risks model and to explore its clinical applicability in mainland China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective, multicenter, observational cohort study including 10\u2009899 women with singleton pregnancy who sought prenatal care at one of 13 hospitals, located in seven cities in mainland China, between 1 December 2017 and 30 December 2019. Mean arterial pressure (MAP), uterine artery pulsatility index (UtA\u2010PI) and maternal serum levels of placental growth factor (PlGF) and pregnancy\u2010associated plasma protein\u2010A (PAPP\u2010A) at 11\u2009+\u20090 to 13\u2009+\u20096\u2009weeks\u2019 gestation were measured and converted into multiples of the median using Chinese reference ranges. Individualized risk for preterm PE was calculated using the FMF algorithm. Prior risk was calculated based on maternal demographic characteristics and obstetric history. We evaluated the efficiency of the screening strategy using various combinations of biomarkers and analyzed its predictive performance for a composite of placenta\u2010associated adverse pregnancy outcomes, including PE, placental abruption, small\u2010for\u2010gestational age (SGA) and preterm birth, at fixed false\u2010positive rates for preterm PE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 312 pregnancies that developed PE, of which 117 cases were diagnosed as preterm PE (&lt;\u200937\u2009weeks' gestation). There were 386 pregnancies complicated by severe composite placenta\u2010associated adverse outcome, including preterm PE, 146 cases of severe SGA (birth weight &lt;\u20093<jats:sup>rd<\/jats:sup> percentile) neonate, 61 cases with placental abruption and 109 cases of early preterm birth &lt;\u200934\u2009gestational weeks. The triple\u2010marker model containing biomarkers MAP, UtA\u2010PI and PAPP\u2010A achieved, at fixed false\u2010positive rates of 10%, 15% and 20%, detection rates for preterm PE of 65.0%, 72.7% and 76.1%, respectively, and detection rates for severe composite placenta\u2010associated adverse outcome of 34.7%, 41.7% and 46.4%, respectively. Replacing PAPP\u2010A with PlGF or adding PlGF to the model did not improve the performance. Of women screening positive for preterm PE at a fixed 5% false\u2010positive rate, an estimated 30% developed at least one  placenta\u2010associated adverse pregnancy outcome, including PE, placental abruption, SGA (birth weight &lt;\u200910<jats:sup>th<\/jats:sup> percentile) and preterm birth &lt;\u200937\u2009weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The FMF competing\u2010risks model for preterm PE was found to be effective in screening a mainland Chinese population. Women who screened positive for preterm PE had increased risk for other placenta\u2010associated pregnancy complications. \u00a9 2021 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.23645","type":"journal-article","created":{"date-parts":[[2021,4,5]],"date-time":"2021-04-05T07:34:54Z","timestamp":1617608094000},"page":"529-539","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Prospective evaluation of first\u2010trimester screening strategy for preterm pre\u2010eclampsia and its clinical applicability in China"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4119-4564","authenticated-orcid":false,"given":"J.","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences, Peking Union Medical College, National 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8095-6605","authenticated-orcid":false,"given":"H.","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Ultrasonic Diagnosis, Peking Union Medical College Hospital Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences, Peking Union Medical College, National 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