{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:46:10Z","timestamp":1793295970923,"version":"4.5.0"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,2]],"date-time":"2024-01-02T00:00:00Z","timestamp":1704153600000},"content-version":"vor","delay-in-days":1,"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":[[2024,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>First, to examine the predictive performance of maternal serum glycosylated fibronectin (GlyFn) at 35\u2009+\u20090 to 36\u2009+\u20096\u2009weeks' gestation in screening for delivery with pre\u2010eclampsia (PE) and delivery with gestational hypertension (GH) at \u2265\u200937\u2009weeks' gestation, both within 3\u2009weeks and at any time after the examination. Second, to compare the predictive performance for delivery with PE and delivery with GH of various combinations of biomarkers, including GlyFn, mean arterial pressure (MAP), uterine artery pulsatility index (UtA\u2010PI), serum placental growth factor (PlGF) and soluble fms\u2010like tyrosine kinase\u20101 (sFlt\u20101). Third, to compare the predictive performance for delivery with PE and delivery with GH by serum PlGF concentration, sFlt\u20101\/PlGF concentration ratio and the competing\u2010risks model with different combinations of biomarkers as above. Fourth, to compare the predictive performance of screening at 11\u2009+\u20090 to 13\u2009+\u20096\u2009weeks <jats:italic>vs<\/jats:italic> 35\u2009+\u20090 to 36\u2009+\u20096\u2009weeks for delivery with PE and delivery with GH at \u2265\u200937\u2009weeks' gestation.<\/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 in stored samples from a non\u2010intervention screening study in singleton pregnancies at 35\u2009+\u20090 to 36\u2009+\u20096\u2009weeks' gestation using a point\u2010of\u2010care device. We used samples from women who delivered at \u2265\u200937\u2009weeks' gestation, including 100 who developed PE, 100 who developed GH and 600 controls who did not develop PE or GH. In all cases, MAP, UtA\u2010PI, PlGF and sFlt\u20101 were measured during the routine visit at 35\u2009+\u20090 to 36\u2009+\u20096\u2009weeks. We used samples from patients that had been examined previously at 11\u2009+\u20090 to 13\u2009+\u20096\u2009weeks' gestation. Levels of GlyFn were transformed to multiples of the expected median (MoM) values after adjusting for maternal demographic characteristics and elements from the medical history. Similarly, the measured values of MAP, UtA\u2010PI, PlGF and sFlt\u20101 were converted to MoM. The competing\u2010risks model was used to combine the prior distribution of the gestational age at delivery with PE, obtained from maternal risk factors, with various combinations of biomarker MoM values to derive the patient\u2010specific risks of delivery with PE. The performance of screening of different strategies was estimated by examining the detection rate (DR) at a 10% fixed false\u2010positive rate (FPR) and McNemar's test was used to compare the DRs between the different methods of screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The DR, at 10% FPR, of screening by the triple test (maternal risk factors plus MAP, PlGF and sFlt\u20101) was 83.7% (95%\u2009CI, 70.3\u201392.7%) for delivery with PE within 3\u2009weeks of screening and 80.0% (95%\u2009CI, 70.8\u201387.3%) for delivery with PE at any time after screening, and this performance was not improved by the addition of GlyFn. The performance of screening by a combination of maternal risk factors, MAP, PlGF and GlyFn was similar to that of the triple test, both for delivery with PE within 3\u2009weeks and at any time after screening. The performance of screening by a combination of maternal risk factors, MAP, UtA\u2010PI and GlyFn was similar to that of the triple test, and they were both superior to screening by low PlGF concentration (PE within 3\u2009weeks: DR, 65.3% (95%\u2009CI, 50.4\u201378.3%); PE at any time: DR, 56.0% (95%\u2009CI, 45.7\u201365.9%)) or high sFlt\u20101\/PlGF concentration ratio (PE within 3\u2009weeks: DR, 73.5% (95%\u2009CI, 58.9\u201385.1%); PE at any time: DR, 63.0% (95%\u2009CI, 52.8\u201372.4%)). The predictive performance of screening at 35\u2009+\u20090 to 36\u2009+\u20096\u2009weeks' gestation for delivery with PE and delivery with GH at \u2265\u200937\u2009weeks' gestation was by far superior to screening at 11\u2009+\u20090 to 13\u2009+\u20096\u2009weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">GlyFn<\/jats:styled-content> is a potentially useful biomarker in third\u2010trimester screening for term <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> and term <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content>, but the findings of this case\u2013control study need to be validated by prospective screening studies. \u00a9 2023 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.27481","type":"journal-article","created":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T10:00:07Z","timestamp":1695117607000},"page":"88-97","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Screening for pre\u2010eclampsia by maternal serum glycosylated fibronectin and angiogenic markers at 36 weeks' gestation"],"prefix":"10.1002","volume":"63","author":[{"given":"N.","family":"Sokratous","sequence":"first","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London 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":"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":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Kakouri","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Laich","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,2]]},"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"},{"issue":"103","key":"e_1_2_8_4_1","first-page":"e1","article-title":"Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 11\u201313\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":"10.1002\/uog.19112"},{"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":"10.1002\/uog.19111"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24789"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26291"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.122.20565"},{"issue":"82","key":"e_1_2_8_11_1","first-page":"e1","article-title":"Maternal serum glycosylated fibronectin as a point\u2010of\u2010care biomarker for assessment of preeclampsia","volume":"212","author":"Rasanen J","year":"2015","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-2809-2"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16323"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26303"},{"issue":"62","key":"e_1_2_8_15_1","first-page":"e1","article-title":"Competing risks model in screening for preeclampsia by maternal characteristics and medical history","volume":"213","author":"Wright D","year":"2015","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(00)00946-7"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000335366"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1975.tb00710.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003018"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003020"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19073"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.11.1247"},{"key":"e_1_2_8_23_1","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2020"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.003215"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414838"},{"issue":"584","key":"e_1_2_8_26_1","first-page":"e1","article-title":"Prediction of imminent preeclampsia at 35\u201337\u2009weeks gestation","volume":"220","author":"Ciobanu A","year":"2019","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.27475"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.27458"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17370"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.27481","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T06:05:08Z","timestamp":1712037908000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.27481"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1002\/uog.27481"],"URL":"https:\/\/doi.org\/10.1002\/uog.27481","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2023-08-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}