{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T23:30:06Z","timestamp":1792279806381,"version":"4.4.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,6,4]],"date-time":"2023-06-04T00:00:00Z","timestamp":1685836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Uteroplacental dysfunction may not only result in pre\u2010eclampsia (PE) but also in preterm birth (PTB), small\u2010for\u2010gestational\u2010age (SGA) birth and stillbirth. The aim of this study is to evaluate the positive predictive value (PPV) of first\u2010trimester combined PE screening for all of these placenta\u2010mediated adverse pregnancy outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary referral maternity unit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>A total of 13\u2009211 singleton pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>First\u2010trimester combined screening for preterm PE using the Fetal Medicine Foundation (FMF) algorithm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcomes measures<\/jats:title><jats:p>Hypertensive disorders of pregnancy (HDP), PTB, SGA birth and stillbirth were combined to assess composite adverse and severe adverse pregnancy outcomes (CAPO and CAPO\u2010S). The PPVs for CAPO and CAPO\u2010S were calculated for women with a combined risk for preterm PE of \u22651 in 50 and \u22651 in 100.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>First\u2010trimester combined screening identified 2215 women (16.8%) with a risk of \u22651 in 100 for preterm PE. The PPVs for a risk of \u22651 in 100 for CAPO and CAPO\u2010S were 38.8% and 18.2%, respectively. The equivalent PPVs for a risk of \u22651 in 50 were 45.1% and 21.1%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women identified at high risk of preterm PE are also at increased risk of other placenta\u2010mediated adverse pregnancy outcomes, such as PTB, SGA birth and stillbirth. Women at high risk for preterm PE after first\u2010trimester screening may benefit from a higher surveillance care pathway, with interventions to mitigate all the adverse outcomes associated with placental dysfunction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17560","type":"journal-article","created":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T02:34:41Z","timestamp":1686105281000},"page":"81-87","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Adverse pregnancy outcomes in women at increased risk of preterm pre\u2010eclampsia on first\u2010trimester combined screening"],"prefix":"10.1111","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8681-4501","authenticated-orcid":false,"given":"Monica","family":"Minopoli","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust  London UK"},{"name":"Department of Medicine and Surgery, 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