{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T13:16:44Z","timestamp":1774444604775,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T00:00:00Z","timestamp":1694217600000},"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":[[2023,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the performance of screening for preterm and term pre\u2010eclampsia (PE) at 11\u201313\u2009weeks' gestation by maternal factors and combinations of maternal serum glycosylated fibronectin (GlyFn), mean arterial pressure (MAP), uterine artery pulsatility index (UtA\u2010PI) and serum placental growth factor (PlGF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a case\u2013control study in which maternal serum GlyFn was measured using a point\u2010of\u2010care device in stored samples from a non\u2010intervention screening study of singleton pregnancies at 11\u2009+\u20090 to 13\u2009+\u20096\u2009weeks' gestation. In the same samples, PlGF was measured by time\u2010resolved fluorometry. We used samples from women who delivered with PE at &lt;\u200937\u2009weeks' gestation (<jats:italic>n\u2009=<\/jats:italic>\u2009100), PE at \u2265\u200937\u2009weeks (<jats:italic>n\u2009=<\/jats:italic>\u2009100), gestational hypertension (GH) at &lt;\u200937\u2009weeks (<jats:italic>n\u2009=<\/jats:italic>\u2009100), GH at \u2265\u200937\u2009weeks (<jats:italic>n\u2009=<\/jats:italic>\u2009100) and 1000 normotensive controls with no pregnancy complications. In all cases, MAP and UtA\u2010PI had been measured during the routine 11\u201313\u2010week visit. Levels of GlyFn were transformed to multiples of the expected median (MoM) values after adjusting for maternal demographic characteristics and elements of medical history. Similarly, the measured values of MAP, UtA\u2010PI and PlGF were converted to MoMs. The competing\u2010risks model was used to combine the prior distribution of gestational age at delivery with PE, obtained from maternal characteristics, with various combinations of biomarker MoM values to derive the patient\u2010specific risks of delivery with PE or GH at &lt;\u200937 and \u2265\u200937\u2009weeks' gestation. Screening performance was estimated by examining the area under the receiver\u2010operating\u2010characteristics curve (AUC) and detection rate (DR) at 10% fixed false\u2010positive rate (FPR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The maternal characteristics and elements of medical history with a significant effect on the measurement of GlyFn were maternal age, weight, height, race, smoking status and history of PE. In pregnancies that developed PE, GlyFn MoM was increased and the deviation from normal decreased with increasing gestational age at delivery. The DR and AUC of screening for delivery with PE at &lt;\u200937\u2009weeks' gestation by maternal factors alone were 50% and 0.834, respectively, and these increased to 80% and 0.949, respectively, when maternal risk factors were combined with MAP, UtA\u2010PI and PlGF (triple test). The performance of the triple test was similar to that of screening by a combination of maternal factors, MAP, UtA\u2010PI and GlyFn (DR, 79%; AUC, 0.946) and that of screening by a combination of maternal factors, MAP, PlGF and GlyFn (DR, 81%; AUC, 0.932). The performance of screening for delivery with PE at \u2265\u200937\u2009weeks' gestation was poor; the DR for screening by maternal factors alone was 35% and increased to only 39% with use of the triple test. Similar results were obtained when GlyFn replaced PlGF or UtA\u2010PI in the triple test. The DR of screening for GH with delivery at &lt;\u200937 and \u2265\u200937\u2009weeks' gestation by maternal factors alone was 34% and 25%, respectively, and increased to 54% and 31%, respectively, with use of the triple test. Similar results were obtained when GlyFn replaced PlGF or UtA\u2010PI in the triple test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>GlyFn is a potentially useful biomarker in first\u2010trimester screening for preterm PE, but the findings of this case\u2013control study need to be validated by prospective screening studies. The performance of screening for term PE or GH at 11\u2009+\u20090 to 13\u2009+\u20096\u2009weeks' gestation by any combination of biomarkers is poor. \u00a9 2023 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.26303","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T13:29:04Z","timestamp":1688477344000},"page":"504-511","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Screening for pre\u2010eclampsia by maternal serum glycosylated fibronectin at 11\u221213\u2009weeks' gestation"],"prefix":"10.1002","volume":"62","author":[{"given":"N.","family":"Sokratous","sequence":"first","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Bednorz","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Sarli","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O. E.","family":"Morillo Montes","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London 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"}]},{"given":"A.","family":"Wright","sequence":"additional","affiliation":[{"name":"Institute of Health Research University of Exeter  Exeter 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":[[2023,9,9]]},"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\/000338470"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000341264"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.02.018"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.08.034"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.11.1247"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19112"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17096"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.07.052"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-2809-2"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16323"},{"key":"e_1_2_8_13_1","unstructured":"National Institute for Health and Care Excellence(2022).Lumella point\u2010of\u2010care test for assessing pre\u2010eclampsia risk.www.nice.org.uk\/guidance\/mib287"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5157"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000335366"},{"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":"10.1097\/AOG.0000000000003018"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003020"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19073"},{"key":"e_1_2_8_20_1","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2020"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17399"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19039"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.11.1087"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.09.041"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26183"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26233"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19111"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26291"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.122.20565"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.26303","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T12:03:49Z","timestamp":1747224229000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.26303"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,9]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1002\/uog.26303"],"URL":"https:\/\/doi.org\/10.1002\/uog.26303","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,9]]},"assertion":[{"value":"2023-06-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}