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We studied 158 pregnancies complicated by pre\u2010eclampsia and 468 normotensive nonproteinuric controls.\n <\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n \n A multicentre study in 16 academic medical centres in the\n USA<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n Low\u2010risk nulliparous women.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Luminex assays for\n PlGF<\/jats:styled-content>\n ,\n sF<\/jats:styled-content>\n lt\u20101 and\n sE<\/jats:styled-content>\n ng performed on maternal\n EDTA<\/jats:styled-content>\n plasma collected at 9\u201312, 15\u201318 and 23\u201326\u00a0weeks of gestation. Rate of change of analyte between first and either early or late second trimester was calculated with and without adjustment for baseline clinical characteristics.\n <\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n \n Change in\n PlGF<\/jats:styled-content>\n ,\n sF<\/jats:styled-content>\n lt\u20101 and\n sE<\/jats:styled-content>\n ng.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Rates of change of\n PlGF<\/jats:styled-content>\n ,\n sE<\/jats:styled-content>\n ng and\n sF<\/jats:styled-content>\n lt\u20101 between first and either early or late second trimesters were significantly different in women who developed pre\u2010eclampsia, severe pre\u2010eclampsia or early\u2010onset pre\u2010eclampsia compared with women who remained normotensive. Inclusion of clinical characteristics (race, body mass index and blood pressure at entry) increased sensitivity for detecting severe and particularly early\u2010onset pre\u2010eclampsia but not pre\u2010eclampsia overall. Receiver operating characteristics curves for change from first to early second trimester in\n sE<\/jats:styled-content>\n ng,\n PlGF<\/jats:styled-content>\n and\n sF<\/jats:styled-content>\n lt\u20101 with clinical characteristics had areas under the curve of 0.88, 0.84 and 0.86, respectively, and for early\u2010onset pre\u2010eclampsia with sensitivities of 88% (95% CI 64\u201399), 77% (95% CI 50\u201393) and 77% (95% CI 50\u201393) for 80% specificity, respectively. Similar results were seen in the change from first to late second trimester.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Change in angiogenic biomarkers between first and early second trimester combined with clinical characteristics has strong utility for predicting early\u2010onset pre\u2010eclampsia.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1471-0528.12128","type":"journal-article","created":{"date-parts":[[2013,1,18]],"date-time":"2013-01-18T05:32:52Z","timestamp":1358487172000},"page":"1183-1191","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":80,"title":["Can changes in angiogenic biomarkers between the first and second trimesters of pregnancy predict development of pre\u2010eclampsia in a low\u2010risk nulliparous patient population?"],"prefix":"10.1111","volume":"120","author":[{"given":"L","family":"Myatt","sequence":"first","affiliation":[{"name":"Department ofObstetrics and Gynecology University of Cincinnati Cincinnati OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RG","family":"Clifton","sequence":"additional","affiliation":[{"name":"The George Washington University Biostatistics Center Washington DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JM","family":"Roberts","sequence":"additional","affiliation":[{"name":"Obstetrics, Gynecology and Reproductive Science University of Pittsburgh Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"CY","family":"Spong","sequence":"additional","affiliation":[{"name":"The Eunice Kennedy Shriver National Institute of Child Health and Human Development Bethesda MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RJ","family":"Wapner","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Columbia University New York NY 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