{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T23:29:55Z","timestamp":1768433395471,"version":"3.49.0"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:00:00Z","timestamp":1693353600000},"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; Gyne"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the performance at 35\u2009+\u20090 to 36\u2009+\u20096\u2009weeks' gestation of screening for delivery with pre\u2010eclampsia (PE) at various timepoints, using one of three approaches: placental growth factor (PlGF) concentration, soluble fms\u2010like tyrosine kinase\u20101 (sFlt\u20101) to PlGF concentration ratio, or the competing\u2010risks model, which combines maternal risk factors with biomarkers to estimate patient\u2010specific risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective observational study of women attending for a routine hospital visit at 35\u2009+\u20090 to 36\u2009+\u20096\u2009weeks' gestation at one of two maternity hospitals in England between 2016 and 2022. During the visit, maternal demographic characteristics and medical history were recorded and serum PlGF, serum sFlt\u20101 and mean arterial pressure (MAP) were measured. Detection rates (DRs) were evaluated for delivery with PE (defined as per American College of Obstetricians and Gynecologists 2019 criteria) within 1\u2009week, within 2\u2009weeks or at any time after screening, using the following strategies: (i) low PlGF (&lt;\u200910<jats:sup>th<\/jats:sup> percentile); (ii) high sFlt\u20101\/PlGF ratio (&gt;\u200990<jats:sup>th<\/jats:sup> percentile); or (iii) the competing\u2010risks model, in which maternal factors were combined with multiples of the median values of PlGF (\u2018single test\u2019), PlGF and sFlt\u20101 (\u2018double test\u2019) or PlGF, sFlt\u20101 and MAP (\u2018triple test\u2019). Risk cut\u2010offs corresponded to a screen\u2010positive rate of 10%. DRs were compared between tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 34\u2009782 pregnancies, 831 (2.4%) developed PE. In screening for delivery with PE at any time from assessment, the DR at 10% screen\u2010positive rate was 47% by low PlGF alone, 54% by the single test, 55% by high sFlt\u20101\/PlGF ratio, 61% by the double test and 68% by the triple test. In screening for delivery with PE within 2\u2009weeks from assessment, the respective values were 67%, 74%, 74%, 80% and 87%. In screening for delivery with PE within 1\u2009week from assessment, the respective values were 77%, 81%, 85%, 88% and 91%. For prediction of PE at any time, the DR was significantly higher with the triple test compared to PlGF alone or the sFlt\u20101\/PlGF ratio, with a DR difference (95%\u2009CI) of 20.1% (16.7\u201323.0%) and 12.4% (9.7\u201315.3%), respectively. Similar results were seen for prediction of PE within 2\u2009weeks (20.6% (14.9\u201326.8%) and 12.9% (7.7\u201317.5%), respectively) and prediction of PE within 1\u2009week (13.5% (5.4\u201321.6%) and 5.4% (0.0\u201310.8%), respectively). The double test was superior to the sFlt\u20101\/PlGF ratio and the single test was superior to PlGF alone in the prediction of PE within 2\u2009weeks and at any time from assessment, but not within 1\u2009week of assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>At 35\u2009+\u20090 to 36\u2009+\u20096\u2009weeks' gestation, the performance of screening for PE by the competing\u2010risks model triple test is superior to that of PlGF alone or the sFlt\u20101\/PlGF ratio for the development of disease within 1\u2009week, within 2\u2009weeks and at any time from screening. \u00a9 2023 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.26291","type":"journal-article","created":{"date-parts":[[2023,6,17]],"date-time":"2023-06-17T15:29:30Z","timestamp":1687015770000},"page":"345-352","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Prediction of hypertensive disorders after screening at 36\u2009weeks' gestation: comparison of angiogenic markers with competing\u2010risks model"],"prefix":"10.1002","volume":"62","author":[{"given":"A.","family":"Schiattarella","sequence":"first","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"},{"name":"Department of Woman, Child and General and Specialized Surgery University of Campania \u2018Luigi Vanvitelli\u2019  Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"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":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Wright","sequence":"additional","affiliation":[{"name":"Institute of Health Research University of Exeter  Exeter UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5856-6072","authenticated-orcid":false,"given":"A.","family":"Syngelaki","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"},{"name":"Institute of Women and Children's Health, School of Life Course and Population Sciences King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"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":[{"role":"author","vocabulary":"crossref"}]},{"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":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2109523"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.11.1247"},{"key":"e_1_2_8_4_1","article-title":"Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 11\u201013\u2009weeks gestation","volume":"214","author":"O'Gorman N","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.10.092"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704559"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.122.20565"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000335366"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003018"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003020"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.003215"},{"issue":"58","key":"e_1_2_8_12_1","first-page":"e1","article-title":"The sFlt\u20101\/PlGF ratio in different types of hypertensive pregnancy disorders and its prognostic potential in preeclamptic patients","volume":"206","author":"Verlohren S","year":"2012","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_13_1","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2020"},{"issue":"584","key":"e_1_2_8_14_1","first-page":"e1","article-title":"Prediction of imminent preeclampsia at 35\u201037\u2009weeks gestation","volume":"220","author":"Ciobanu A","year":"2019","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414838"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.3109\/10641955.2016.1141214"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004149"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.11.016"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.02.016"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15812"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61351-7"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17296"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.26291","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T20:25:45Z","timestamp":1693945545000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.26291"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,30]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1002\/uog.26291"],"URL":"https:\/\/doi.org\/10.1002\/uog.26291","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,30]]},"assertion":[{"value":"2023-05-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}