{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:28:23Z","timestamp":1787668103491,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"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":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess whether pregnancy\u2010associated plasma protein\u2010A (PAPP\u2010A) alters or provides equivalent screening performance as placental growth factor (PlGF) when screening for preterm pre\u2010eclampsia (PE) at 11\u201313\u2009weeks of gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a secondary analysis of a non\u2010intervention screening study of 6546 singleton pregnancies that were screened prospectively for preterm PE in the first trimester between December 2016 and June 2018. Patient\u2010specific risks for preterm PE were estimated by maternal history, mean arterial pressure (MAP), uterine artery pulsatility index (UtA\u2010PI), PlGF and PAPP\u2010A. A competing\u2010risks model with biomarkers expressed as multiples of the median was used. All women and clinicians were blinded to the risk for preterm PE. The performance of screening for preterm PE using PlGF <jats:italic>vs<\/jats:italic> PAPP\u2010A <jats:italic>vs<\/jats:italic> both PAPP\u2010A and PlGF was assessed by comparing areas under the receiver\u2010operating\u2010characteristics (AUC) curves. McNemar's test was used to compare detection rate at a fixed false\u2010positive rate (FPR) of 10%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>PlGF and PAPP\u2010A were measured in 6546 women, of whom 37 developed preterm PE. The AUC and detection rate at 10% FPR using PlGF in combination with maternal history, MAP and UtA\u2010PI were 0.854 and 59.46%, respectively. The respective values were 0.813 and 51.35% when replacing PlGF with PAPP\u2010A and 0.855 and 59.46% when using both PAPP\u2010A and PlGF. Statistically non\u2010significant differences were noted in AUC when replacing PlGF with PAPP\u2010A (\u0394AUC, 0.04; <jats:italic>P<\/jats:italic>\u2009=\u20090.095) and when using both PAPP\u2010A and PlGF (\u0394AUC, 0.002; <jats:italic>P<\/jats:italic>\u2009=\u20090.423). However, on an individual case basis, screening using PlGF in conjunction with maternal history, MAP and UtA\u2010PI identified three (8.1%) additional pregnancies that developed preterm PE and that were not identified when replacing PlGF with PAPP\u2010A. Screening using PAPP\u2010A in addition to maternal history and other biomarkers did not identify any additional pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>On an individual case basis, adoption of a screening strategy that uses PAPP\u2010A instead of PlGF results in reduced detection of preterm PE, consistent with previous literature. \u00a9 2022 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.24918","type":"journal-article","created":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T19:33:50Z","timestamp":1650915230000},"page":"200-206","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Impact of replacing or adding pregnancy\u2010associated plasma <scp>protein\u2010A<\/scp> at 11\u201313\u2009weeks on screening for preterm pre\u2010eclampsia"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4586-6054","authenticated-orcid":false,"given":"Y. M. I.","family":"Wah","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong, Prince of Wales Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3755-2701","authenticated-orcid":false,"given":"D. S.","family":"Sahota","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong, Prince of Wales Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Chaemsaithong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong, Prince of Wales Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong, Prince of Wales Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4140-6651","authenticated-orcid":false,"given":"A. H. W.","family":"Kwan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong, Prince of Wales Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5115-3977","authenticated-orcid":false,"given":"Y. H.","family":"Ting","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong, Prince of Wales Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. M.","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong, Prince of Wales Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9153-0343","authenticated-orcid":false,"given":"T. Y.","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong, Prince of Wales Hospital  Hong Kong SAR China"}],"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 The Chinese University of Hong Kong, Prince of Wales Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8]]},"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":"10.1016\/j.ajog.2018.02.014"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22193"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19076"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16361"},{"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":"10.3310\/hta24720"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.121.18021"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22140"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2016.03.046"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5986"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22093"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17399"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-04283-6"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19112"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23669"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.09.041"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000335366"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2017.08.002"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5157"},{"key":"e_1_2_8_22_1","volume-title":"Hypertension in Pregnancy: The Management of Hypertensive Disorders During Pregnancy","author":"National Institute for Health and Care Excellence","year":"2010"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2019.06.004"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2010.531310"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6340"},{"key":"e_1_2_8_26_1","volume-title":"Mini\u2010combined test compared with NICE guidelines for early risk\u2010assessment for pre\u2010eclampsia: the SPREE diagnostic accuracy study","author":"Poon LC","year":"2020"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21905"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6252"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1081\/PRG-100104165"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000437382.03963.88"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.2307\/2531595"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.09.076"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60712-0"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.96.6.3149"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.116.06421"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2008.11.009"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2010.07.015"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.24918","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.24918","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.24918","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T04:00:48Z","timestamp":1692763248000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.24918"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8]]},"references-count":36,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,8]]}},"alternative-id":["10.1002\/uog.24918"],"URL":"https:\/\/doi.org\/10.1002\/uog.24918","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8]]},"assertion":[{"value":"2022-01-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}