{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:31:02Z","timestamp":1780374662993,"version":"3.54.1"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,9,1]],"date-time":"2014-09-01T00:00:00Z","timestamp":1409529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the performance of a multivariable model combining <jats:italic>a priori<\/jats:italic> clinical characteristics and biomarkers to detect, early in pregnancy, women at higher risk of developing pre\u2010eclampsia (<jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Nested case\u2013control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>University medical centre, <jats:styled-content style=\"fixed-case\">Q<\/jats:styled-content>uebec, <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>anada (<jats:styled-content style=\"fixed-case\">CHU<\/jats:styled-content> de <jats:styled-content style=\"fixed-case\">Q<\/jats:styled-content>u\u00e9bec).<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>A total of 7929 pregnant women recruited between 10 and 18\u00a0weeks of gestation. In all, 350 developed hypertensive disorders of pregnancy (<jats:styled-content style=\"fixed-case\">HDP<\/jats:styled-content>)\u2014of which 139 had <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>, comprising 68 with severe <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> and 47 with preterm <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>\u2014and were matched with two women with a normal pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We selected <jats:italic>a priori<\/jats:italic> clinical characteristics and promising markers to create multivariable logistic regression models: body mass index (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>), mean arterial pressure (<jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content>), placental growth factor, soluble Fms\u2010like tyrosine kinase\u20101, pregnancy\u2010associated plasma protein A and inhibin A.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>, severe <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>, preterm <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> HDP<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At false\u2010positive rates of 5 and 10%, the estimated detection rates were between 15% (5\u201329%) and 32% (25\u201339%), and between 39% (19\u201359%) and 50% (34\u201366%), respectively. Considering the low prevalence of <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> in this population, the positive predictive values were 7% (5\u20139%) to 10% (7\u201313%) for <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> and 2% (1\u20134%) to 4% (3\u20136%) in the preterm and severe <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> subgroups. The multivariable model yielded areas under the receiver operating characteristics curves (<jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>) between 0.72 (0.61\u20130.81) and 0.78 (0.68\u20130.88). When only <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content> were included in the model, the <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> were similar to those of the <jats:italic>a priori<\/jats:italic> model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In a population with a low prevalence of preterm <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>, a multivariable risk algorithm using an <jats:italic>a priori<\/jats:italic> combination of clinical characteristics and biochemical markers did not reach a performance justifying clinical implementation as screening test early in pregnancy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13050","type":"journal-article","created":{"date-parts":[[2014,9,1]],"date-time":"2014-09-01T07:13:23Z","timestamp":1409555603000},"page":"402-410","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Screening for pre\u2010eclampsia early in pregnancy: performance of a multivariable model combining clinical characteristics and biochemical markers"],"prefix":"10.1111","volume":"122","author":[{"given":"Y","family":"Gigu\u00e8re","sequence":"first","affiliation":[{"name":"Department of Molecular Biology, Medical Biochemistry and Pathology Faculty of Medicine Universit\u00e9 Laval Qu\u00e9bec QC Canada"},{"name":"CHU de Qu\u00e9bec Research Centre H\u00f4pital St\u2010Fran\u00e7ois d'Assise Quebec City QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Mass\u00e9","sequence":"additional","affiliation":[{"name":"Department of 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