{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:43:50Z","timestamp":1790613830597,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T00:00:00Z","timestamp":1630886400000},"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","award":["1037116"],"award-info":[{"award-number":["1037116"]}],"id":[{"id":"10.13039\/501100003123","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011272","name":"FP7 Health","doi-asserted-by":"publisher","award":["601852"],"award-info":[{"award-number":["601852"]}],"id":[{"id":"10.13039\/100011272","id-type":"DOI","asserted-by":"publisher"}]}],"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>Objective<\/jats:title><jats:p>To examine the possible risk factors amongst maternal characteristics, medical and obstetric history, pre\u2010eclampsia (PE)\u2010specific biomarkers and estimated\u2010risk group, according to The Fetal Medicine Foundation (FMF) algorithm, that are associated with the development of preterm PE with delivery at &lt;\u200937\u2009weeks' gestation despite aspirin prophylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a secondary analysis of data from the ASPRE trial. The study population consisted of women with singleton pregnancy who were deemed to be at high risk for preterm PE, based on the FMF algorithm that combines maternal factors, mean arterial pressure, uterine artery pulsatility index, serum pregnancy\u2010associated plasma protein\u2010A and placental growth factor (PlGF) at 11\u201313\u2009weeks' gestation. High\u2010risk women were randomized to receive aspirin (150\u2009mg\/day) <jats:italic>vs<\/jats:italic> placebo from 11\u201314 until 36\u2009weeks' gestation. The primary outcome was PE with delivery at &lt;\u200937\u2009weeks' gestation (preterm PE). Multivariate logistic regression analysis was performed to identify independent predictors of preterm PE after adjusting for the use of aspirin and other covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1592 high\u2010risk women, the incidence of preterm PE was 3.0% (<jats:italic>n<\/jats:italic>\u2009=\u200948). The interaction between aspirin usage and history of chronic hypertension was significant in the prediction of preterm PE (<jats:italic>P<\/jats:italic>\u2009=\u20090.042), which indicated that there was no treatment effect in high\u2010risk women who had chronic hypertension compared with those who did not. Adjusting for aspirin use, the interaction between aspirin and chronic hypertension and other covariates, independent predictors for the development of preterm PE were PlGF multiples of the median (MoM) (adjusted odds ratio (aOR), 0.226 (95%\u2009CI, 0.070\u20130.723)) and estimated\u2010risk group based on the FMF algorithm. Compared to women with an estimated risk of 1 in 51 to 1 in 100, those with an estimated risk of 1 in 2 to 1 in 10 had a 7\u2010fold higher risk of developing preterm PE (aOR, 6.706 (95%\u2009CI, 2.381\u201318.883)), and those with an estimated risk of 1 in 11 to 1 in 50 had a 3\u2010fold higher risk of preterm PE (aOR, 2.769 (95%\u2009CI, 1.105\u20136.939)). PlGF MoM was an independent predictor for preterm PE among women with an estimated risk of 1 in 2 to 1 in 10 (aOR, 0.055 (95%\u2009CI, 0.005\u20130.668)). Among women with an estimated risk of 1 in 11 to 1 in 100, the use of aspirin was an independent predictor of preterm PE (aOR, 0.276 (95%\u2009CI, 0.111\u20130.689)). The cut\u2010off for PlGF with the best performance for the prediction of preterm PE was 0.712 MoM, with an aOR of 3.677 (95%\u2009CI, 1.526\u20138.862).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In pregnancies at high risk of preterm PE identified by screening at 11\u201313\u2009weeks' gestation using the FMF algorithm, a very high\u2010risk result (estimated risk \u2265\u20091 in 50), compared to an estimated risk of 1 in 51 to 1 in 100, chronic hypertension, compared to no chronic hypertension, and low PlGF concentration (&lt;\u20090.712\u2009MoM), compared to PlGF \u2265\u20090.712\u2009MoM, were associated with the development of preterm PE despite aspirin prophylaxis. \u00a9 2021 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.23668","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T05:53:51Z","timestamp":1621230831000},"page":"546-552","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["<scp>ASPRE<\/scp> trial: risk factors for development of preterm pre\u2010eclampsia despite aspirin prophylaxis"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7573-2498","authenticated-orcid":false,"given":"L.","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Prince of Wales Hospital The Chinese University of Hong Kong  Shatin, Hong Kong SAR China"},{"name":"Department of Obstetrics and Gynecology The First Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4711-3857","authenticated-orcid":false,"given":"R. J.","family":"Martinez\u2010Portilla","sequence":"additional","affiliation":[{"name":"Clinical Research Division, National Institute of Perinatology \u201cIsidro Espinosa de lo Reyes\u201d  Mexico City Mexico"},{"name":"Iberoamerican Research Network in Obstetrics Gynecology and Translational Medicine  Mexico City Mexico"},{"name":"Fetal Medicine Research Center, BCNatal, Barcelona Center for Maternal\u2013Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), Institut Cl\u00ednic de Ginecologia, Obstetricia i Neonatologia Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2263-3592","authenticated-orcid":false,"given":"D. L.","family":"Rolnik","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University  Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3944-4130","authenticated-orcid":false,"given":"L. C.","family":"Poon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Prince of Wales Hospital The Chinese University of Hong Kong  Shatin, Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704559"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000341264"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.07.038"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.08.110"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17399"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.08.034"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.11.1247"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.02.018"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000335366"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5157"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14783"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14789"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14870"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14811"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1975.tb00710.x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.3109\/10641950109152635"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.02.034"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000118"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.18992"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22093"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1994.04040342.x"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20859"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.23668","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.23668","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.23668","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,27]],"date-time":"2023-08-27T11:01:10Z","timestamp":1693134070000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.23668"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,6]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1002\/uog.23668"],"URL":"https:\/\/doi.org\/10.1002\/uog.23668","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,6]]},"assertion":[{"value":"2021-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}