{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T11:41:46Z","timestamp":1791718906268,"version":"4.3.4"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T00:00:00Z","timestamp":1696291200000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007406","name":"Fundaci\u00f3n BBVA","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007406","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI18\/01749"],"award-info":[{"award-number":["PI18\/01749"]}],"id":[{"id":"10.13039\/501100004587","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":[[2023,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the diagnostic accuracy of the Fetal Medicine Foundation (FMF) competing\u2010risks model, incorporating maternal characteristics, mean arterial pressure (MAP), uterine artery pulsatility index (UtA\u2010PI) and placental growth factor (PlGF) (the \u2018triple test\u2019), for the prediction at 11\u201313\u2009weeks' gestation of preterm pre\u2010eclampsia (PE) in a Spanish population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a prospective cohort study performed in eight fetal medicine units in five different regions of Spain between September 2017 and December 2019. All pregnant women with a singleton pregnancy and a non\u2010malformed live fetus attending a routine ultrasound examination at 11\u2009+\u20090 to 13\u2009+\u20096\u2009weeks' gestation were invited to participate. Maternal demographic characteristics and medical history were recorded and MAP, UtA\u2010PI, serum PlGF and pregnancy\u2010associated plasma protein\u2010A (PAPP\u2010A) were measured following standardized protocols. Treatment with aspirin during pregnancy was also recorded. Raw values of biomarkers were converted into multiples of the median (MoM), and audits were performed periodically to provide regular feedback to operators and laboratories. Patient\u2010specific risks for term and preterm PE were calculated according to the FMF competing\u2010risks model, blinded to pregnancy outcome. The performance of screening for PE, taking into account aspirin use, was assessed by calculating the area under the receiver\u2010operating\u2010characteristics curve (AUC) and detection rate (DR) at a 10% fixed screen\u2010positive rate (SPR). Risk calibration of the model was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study population comprised 10\u2009110 singleton pregnancies, including 72 (0.7%) that developed preterm PE. In the preterm PE group, compared to those without PE, median MAP MoM and UtA\u2010PI MoM were significantly higher, and median serum PlGF MoM and PAPP\u2010A MoM were significantly lower. In women with PE, the deviation from normal in all biomarkers was inversely related to gestational age at delivery. Screening for preterm PE by a combination of maternal characteristics and medical history with MAP, UtA\u2010PI and PlGF had a DR, at 10% SPR, of 72.7% (95%\u2009CI, 62.9\u201382.6%). An alternative strategy of replacing PlGF with PAPP\u2010A in the triple test was associated with poorer screening performance for preterm PE, giving a DR of 66.5% (95%\u2009CI, 55.8\u201377.2%). The calibration plot showed good agreement between predicted risk and observed incidence of preterm PE, with a slope of 0.983 (95%\u2009CI, 0.846\u20131.120) and an intercept of 0.154 (95%\u2009CI, \u22120.091 to 0.397).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The FMF model is effective in predicting preterm PE in the Spanish population at 11\u201313\u2009weeks' gestation. This method of screening is feasible to implement in routine clinical practice, but it should be accompanied by a robust audit and monitoring system, in order to maintain high\u2010quality screening. \u00a9 2023 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.26233","type":"journal-article","created":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T16:47:52Z","timestamp":1682527672000},"page":"522-530","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Performance of first\u2010trimester combined screening for preterm pre\u2010eclampsia: findings from cohort of 10 110 pregnancies in Spain"],"prefix":"10.1002","volume":"62","author":[{"given":"D.","family":"Cuenca\u2010G\u00f3mez","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitario de Torrej\u00f3n, Torrej\u00f3n de Ardoz  Madrid Spain"},{"name":"Faculty of Medicine Universidad Francisco de Vitoria, Pozuelo de Alarc\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"De Paco Matallana","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Cl\u00ednico Universitario Virgen de la Arrixaca, El Palmar  Murcia Spain"},{"name":"Institute for Biomedical Research of Murcia, IMIB\u2010Arrixaca, El Palmar  Murcia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Rolle","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitario de Torrej\u00f3n, Torrej\u00f3n de Ardoz  Madrid Spain"},{"name":"Biostatistics and Epidemiology Platform Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias  Oviedo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Vali\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Complejo Hospitalario Universitario A Coru\u00f1a  A Coru\u00f1a Galicia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Revello","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitario Quir\u00f3n, Pozuelo de Alarc\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Adiego","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitario Fundaci\u00f3n de Alcorc\u00f3n, Alcorc\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Mendoza","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitario Vall d'Hebr\u00f3n  Barcelona Catalonia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. S.","family":"Molina","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Cl\u00ednico Universitario San Cecilio  Granada Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria (Ibs.GRANADA)  Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. P.","family":"Carrillo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitario Virgen de las Nieves  Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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