{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T03:08:44Z","timestamp":1789528124332,"version":"build-2803163510"},"reference-count":40,"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:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"publisher","award":["18190821"],"award-info":[{"award-number":["18190821"]}],"id":[{"id":"10.13039\/501100005847","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><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine whether maternal serum glycosylated fibronectin (GlyFn) level in the first trimester increases the sensitivity of the Fetal Medicine Foundation (FMF) triple test, which incorporates mean arterial pressure, uterine artery pulsatility index and placental growth factor, when screening for pre\u2010eclampsia (PE) in an Asian population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a nested case\u2013control study of Chinese women with a singleton pregnancy who were screened for PE at 11\u201313\u2009weeks' gestation as part of a non\u2010intervention study between December 2016 and June 2018. GlyFn levels were measured retrospectively in archived serum from 1685 pregnancies, including 101 with PE, using an enzyme\u2010linked immunosorbent assay (ELISA), and from 448 pregnancies, including 101 with PE, using a point\u2010of\u2010care (POC) device. Concordance between ELISA and POC tests was assessed using Lin's correlation coefficient and Passing\u2013Bablok and Bland\u2013Altman analyses. GlyFn was transformed into multiples of the  median (MoM) to adjust for maternal and pregnancy characteristics. GlyFn MoM was compared between PE and non\u2010PE pregnancies, and the association between GlyFn MoM and gestational age at delivery with PE was assessed. Risk for developing PE was estimated using the FMF competing\u2010risks model. Screening performance for preterm and any\u2010onset PE using different biomarker combinations was quantified by area under the receiver\u2010operating\u2010characteristics curve (AUC) and detection rate (DR) at a 10% fixed false\u2010positive rate (FPR). Differences in AUC between biomarker combinations were compared using the DeLong test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The concordance correlation coefficient between ELISA and POC measurements was 0.86 (95%\u2009CI, 0.83\u20130.88). Passing\u2013Bablok analysis indicated proportional bias (slope, 1.08 (95%\u2009CI, 1.04\u20131.14)), with POC GlyFn being significantly higher compared with ELISA GlyFn. ELISA GlyFn in non\u2010PE pregnancies was independent of gestational age at screening (<jats:italic>P<\/jats:italic>\u2009=\u20090.11), but significantly dependent on maternal age (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.003), weight (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0002), height (<jats:italic>P<\/jats:italic>\u2009=\u20090.001), parity (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.02) and smoking status (<jats:italic>P<\/jats:italic>\u2009=\u20090.002). Compared with non\u2010PE pregnancies, median GlyFn MoM using ELISA and POC testing was elevated significantly in those with preterm PE (1.23 <jats:italic>vs<\/jats:italic> 1.00; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001 and 1.18 <jats:italic>vs<\/jats:italic> 1.00; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001, respectively) and those with term PE (1.26 <jats:italic>vs<\/jats:italic> 1.00; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001 and 1.22 <jats:italic>vs<\/jats:italic> 1.00; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001, respectively). GlyFn MoM was not correlated with gestational age at delivery with PE (<jats:italic>P<\/jats:italic>\u2009=\u20090.989). Adding GlyFn to the FMF triple test for preterm PE increased significantly the AUC from 0.859 to 0.896 (<jats:italic>P<\/jats:italic>\u2009=\u20090.012) and increased the DR at 10% FPR from 64.9% (95%\u2009CI, 48.7\u201381.1%) to 82.9% (95%\u2009CI, 66.4\u201393.4%). The corresponding DRs at 10% FPR for any\u2010onset PE were 52.5% (95%\u2009CI, 42.3\u201362.5%) and 65.4% (95%\u2009CI, 55.2\u201374.5%), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adding GlyFn to the FMF triple test increased the screening sensitivity for both preterm and any\u2010onset PE in an Asian population. Prospective non\u2010intervention studies are needed to confirm these initial findings. \u00a9 2023 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.27451","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T19:38:14Z","timestamp":1692905894000},"page":"512-521","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Glycosylated fibronectin improves first\u2010trimester prediction of pre\u2010eclampsia"],"prefix":"10.1002","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7239-5705","authenticated-orcid":false,"given":"S.","family":"Moungmaithong","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Siriraj Hospital, Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. S. L.","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. W. T.","family":"Tse","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Prince of Wales Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. M. W.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. H. Y.","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong  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  Hong Kong SAR China"},{"name":"Shenzhen Research Institute The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3755-2701","authenticated-orcid":false,"given":"D. 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