{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:36:30Z","timestamp":1787315790684,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T00:00:00Z","timestamp":1744934400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T00:00:00Z","timestamp":1744934400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"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 & Gyne"],"published-print":{"date-parts":[[2025,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To stratify pregnancy care based on the estimated risk of pre\u2010eclampsia (PE) from screening at 19\u201324\u2009weeks' gestation by combinations of maternal risk factors, estimated fetal weight (EFW), mean arterial pressure (MAP) and uterine artery pulsatility index (UtA\u2010PI).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The data for this study were derived from a prospective non\u2010interventional study in 134\u2009443 women with a singleton pregnancy attending for a routine ultrasound scan at 19\u2009+\u20090 to 23\u2009+\u20096\u2009weeks' gestation in two UK maternity hospitals. The visit included recording of maternal demographic characteristics and medical history, sonographic EFW and measurement of MAP and UtA\u2010PI. The competing\u2010risks model was used to estimate the individual patient\u2010specific risk of delivery with PE at <\u200928, <\u200932 and <\u200936\u2009weeks' gestation. Receiver\u2010operating\u2010characteristics curves were constructed for screen\u2010positive rates (SPRs) at different detection rates of delivery with PE at <\u200928, <\u200932 and <\u200936\u2009weeks' gestation for the combinations of maternal risk factors, EFW and MAP, and of maternal risk factors, EFW, MAP and UtA\u2010PI. Different risk cut\u2010offs were used with the intention of detecting about 80%, 85% and 90% of cases of delivery with PE at <\u200928, <\u200932 and <\u200936\u2009weeks' gestation. Calibration for risk of delivery with PE at <\u200928, <\u200932 and <\u200936\u2009weeks' gestation was assessed by plotting the observed incidence of PE against the predicted incidence of PE.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The study population contained 4335 (3.2%) women that subsequently developed PE, including 64 (0.05%) that delivered with PE at <\u200928\u2009weeks' gestation, 209 (0.2%) that delivered with PE at <\u200932\u2009weeks and 655 (0.5%) that delivered with PE at <\u200936\u2009weeks. If the objective of screening was to identify about 90% of cases of delivery with PE at <\u200928, <\u200932 and <\u200936\u2009weeks and the method of screening was a combination of maternal risk factors, EFW and MAP, the respective SPRs would be 11.0%, 18.3% and 38.8%. If the method of screening also included UtA\u2010PI, the respective SPRs would be 2.6%, 3.8% and 23.6%. If the objective of screening was to identify about 80% of cases of delivery with PE at <\u200928, <\u200932 and <\u200936\u2009weeks and the method of screening was a combination of maternal risk factors, EFW and MAP, the respective SPRs would be 5.9%, 9.7% and 21.9%. If the method of screening also included UtA\u2010PI, the respective SPRs would be 1.0%, 2.1% and 11.7%. The calibration plots demonstrated good agreement between the estimated risk and observed incidence of PE.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n All women should be offered assessment of risk for PE at 11\u201313\u2009weeks, to help identify those requiring aspirin prophylaxis to reduce the rate of preterm PE, and at 35\u201337\u2009weeks, to determine the optimal timing of birth to reduce the rate of term PE. Assessment of risk for PE at mid\u2010gestation can be used to identify the subgroups that require additional monitoring at 24\u201335, 28\u201335\u2009and 32\u201335\u2009weeks' gestation. The best performance of screening, reflected in the SPR necessary to achieve a high detection rate, is achieved by a combination of maternal risk factors, MAP and UtA\u2010PI. \u00a9 2025 The Author(s).\n Ultrasound in Obstetrics & Gynecology<\/jats:italic>\n published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/uog.29222","type":"journal-article","created":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T06:25:02Z","timestamp":1744957502000},"page":"694-702","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Assessment of risk for pre\u2010eclampsia at mid\u2010gestation to define subsequent care"],"prefix":"10.1002","volume":"65","author":[{"given":"S.","family":"Adjahou","sequence":"first","affiliation":[{"name":"Fetal Medicine Research Institute, King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Logdanidis","sequence":"additional","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"}]},{"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1266-0711","authenticated-orcid":false,"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":[[2025,4,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2109523"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.11.1247"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.08.034"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15812"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24789"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704559"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.122.20565"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.11.016"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19099"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24829"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23623"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(85)90298-4"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19066"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000335366"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0960-7692.2001.00572.x"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200010000-00015"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1975.tb00710.x"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000437382.03963.88"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19073"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14789"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14783"},{"key":"e_1_2_7_23_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2023"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/155.3.203"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5252"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.08.019"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2017.09.003"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17418"}],"container-title":["Ultrasound in Obstetrics & Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.29222","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.29222","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.29222","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:28:29Z","timestamp":1781245709000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.29222"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,18]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1002\/uog.29222"],"URL":"https:\/\/doi.org\/10.1002\/uog.29222","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,18]]},"assertion":[{"value":"2025-01-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}