{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T15:53:01Z","timestamp":1793893981062,"version":"4.8.0"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"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 &amp;amp; Gyne"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The competing\u2010risks model for assessment of risk for pre\u2010eclampsia (PE) at 35\u201337\u2009weeks' gestation identifies the majority of women who are at high risk of subsequent delivery with PE. We aimed to examine the incidence and relative risk of adverse pregnancy outcomes in patient groups stratified according to the estimated risk of delivery with PE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective non\u2010interventional, observational study in women with a singleton pregnancy attending for a routine hospital visit at 35\u2009+\u20090 to 36\u2009+\u20096\u2009weeks' gestation. The risk of delivery with PE for each patient in the study population was estimated using the competing\u2010risks model, combining the prior distribution of gestational age at delivery with PE and the likelihood from multiples of the median values of mean arterial pressure, placental growth factor and soluble fms\u2010like tyrosine kinase\u20101. The patients were assigned to one of the following five risk categories: Group A, \u2265\u20091 in 2; Group B, 1 in 5 to 1 in 3; Group C, 1 in 20 to 1 in 6; Group D, 1 in 50 to 1 in 21; and Group E, <jats:italic>&lt;<\/jats:italic>\u20091 in 50. The outcome measures were delivery with PE, gestational hypertension (GH), small\u2010for\u2010gestational age (SGA) at birth, delivery by Cesarean section, stillbirth, neonatal death, perinatal death and admission to the neonatal unit (NNU) for at least 48\u2009h. In each risk category, the proportion of women with each adverse outcome was determined and relative risks (RR) were calculated as compared with the lowest\u2010risk Group E.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the study population of 29\u2009035 women, 1.6%, 2.7%, 8.2%, 9.8% and 77.8% were categorized into Groups A, B, C, D and E, respectively. Compared with women in Group E, women in the higher\u2010risk groups were more likely to have an adverse outcome. The RR of delivery with PE in Group A compared with Group E was 65.5 (95%\u2009CI, 54.1\u201379.1) and the respective values were 11.9 (95%\u2009CI, 9.1\u201315.5) for GH, 1.8 (95%\u2009CI,\u20091.5\u20132.1) for delivery by emergency Cesarean section, 1.5 (95%\u2009CI, 1.2\u20131.8) for delivery by elective Cesarean section, 8.9 (95%\u2009CI,\u20097.4\u201310.8) for SGA with birth weight <jats:italic>&lt;<\/jats:italic>\u20093<jats:sup>rd<\/jats:sup> percentile, 4.8 (95%\u2009CI,\u20094.3\u20135.4) for SGA with birth weight <jats:italic>&lt;<\/jats:italic>\u200910<jats:sup>th<\/jats:sup> percentile, 5.3 (95%\u2009CI, 1.4\u201320.5) for stillbirth and 3.4 (95%\u2009CI, 2.8\u20134.2) for NNU admission for \u2265\u200948\u2009h. The RR for these pregnancy complications in higher\u2010risk groups (<jats:italic>vs<\/jats:italic> Group E) was particularly high for cases with delivery within 2\u2009weeks after assessment. In terms of SGA, both for birth weight <jats:italic>&lt;<\/jats:italic>\u200910<jats:sup>th<\/jats:sup> and <jats:italic>&lt;<\/jats:italic>\u20093<jats:sup>rd<\/jats:sup> percentiles, the trend in all cases was stronger than that observed when the analysis was confined to normotensive pregnancies. The rates of neonatal death were too small to allow meaningful comparisons between risk groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pregnant women identified by the competing\u2010risks model to be at high risk of PE are also at increased risk of GH, Cesarean section, stillbirth, SGA and NNU admission for \u2265\u200948\u2009h. \u00a9 2022 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.26036","type":"journal-article","created":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T14:02:26Z","timestamp":1658498546000},"page":"367-372","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Competing\u2010risks model for pre\u2010eclampsia and adverse pregnancy outcomes"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5856-6072","authenticated-orcid":false,"given":"A.","family":"Syngelaki","sequence":"first","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1355-610X","authenticated-orcid":false,"given":"L. A.","family":"Magee","sequence":"additional","affiliation":[{"name":"Institute of Women and Children's Health School of Life Course and Population Sciences, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"von Dadelszen","sequence":"additional","affiliation":[{"name":"Institute of Women and Children's Health School of Life Course and Population Sciences, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7265-5442","authenticated-orcid":false,"given":"R.","family":"Akolekar","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Medway Maritime Hospital  Gillingham UK"},{"name":"Institute of Medical Sciences Canterbury Christ Church University  Chatham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Wright","sequence":"additional","affiliation":[{"name":"Institute of Health Research University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Wright","sequence":"additional","affiliation":[{"name":"Institute of Health Research University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. 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