{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T06:29:22Z","timestamp":1769754562947,"version":"3.49.0"},"reference-count":37,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T00:00:00Z","timestamp":1659571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background and Objectives: The study aimed to evaluate the ability defining the risk of developing preeclampsia by a screening test carried out in the first trimester (between 11 + 0 and 13 + 6 weeks of gestational age), in order to identify high-risk women requiring more intensive health surveillance. The secondary objective was to evaluate the ability of this test to predict the risk of adverse obstetric outcomes such as fetal growth restriction, intrauterine fetal death, gestational hypertension, HELLP syndrome, placental abruption, and preterm birth. Materials and Methods: This was a single-center study, conducted at the Operative Unit of Obstetrics of the State Hospital of the Republic of San Marino. Medical history was collected at the time of enrolment in writing. Subsequently, obstetric outcomes were collected for each enrolled woman, through the analysis of medical records. Results: From October 2014 to May 2019, 589 pregnant women were recruited, of whom, 474 (80.5%) were included in the \u201clow-risk\u201d group, and 115 (19.5%) in the \u201chigh-risk\u201d group. At the time of analysis of this population, the obstetric outcomes were available for 498 women (84.5%), while 91 cases (15.5%) were current pregnancies. The PI of the uterine arteries was not significantly different between the two study groups. Otherwise, a significant difference was highlighted for MAP, which is higher in the case of pregnancies at high risk based on the risk factors only, and for PAPP-A, higher in the case of low-risk pregnancies. Regarding the percentage of fetal DNA, according to the most recent literature data, in our series, we report a statistically significant difference of the average between the low and high-risk groups. Conclusions: In our study, we demonstrate that the multiparametric screening test for early PE performed well in identifying women at high risk of early PE, which certainly has the most severe maternal\u2013fetal outcomes. The data reported that ASA intake at low doses is significantly higher in the population with high-risk tests for both early PE and late PE suggest once again that anamnestic evaluation plays an essential role in women\u2019s screening.<\/jats:p>","DOI":"10.3390\/jcm11154555","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T21:52:48Z","timestamp":1659649968000},"page":"4555","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Results of a Five-Year Experience in First Trimester Preeclampsia Screening"],"prefix":"10.3390","volume":"11","author":[{"given":"Stella","family":"Capriglione","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Ospedale \u201cSanta Maria Alla Gruccia\u201d Piazza del Volontariato 2, 52025 Montevarchi, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7910-0386","authenticated-orcid":false,"given":"Ferdinando Antonio","family":"Gulino","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Azienda di Rilievo Nazionale e Alta Specializzazione (ARNAS) Garibaldi, Via Palermo 636, 95126 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Latella","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Istituto per la Sicurezza Sociale, 47893 Cailungo, Borgo Maggiore, San Marino"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanna","family":"De Felice","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Istituto per la Sicurezza Sociale, 47893 Cailungo, Borgo Maggiore, San Marino"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Filippini","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Istituto per la Sicurezza Sociale, 47893 Cailungo, Borgo Maggiore, San Marino"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Farinelli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Istituto per la Sicurezza Sociale, 47893 Cailungo, Borgo Maggiore, San Marino"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0756-535X","authenticated-orcid":false,"given":"Francesco Giuseppe","family":"Martire","sequence":"additional","affiliation":[{"name":"Gynecological Unit, Department of Surgical Sciences, University of Rome \u201cTor Vergata\u201d, 00133 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elsa","family":"Viora","sequence":"additional","affiliation":[{"name":"Obstetrical-Gynecological Ultrasound Unit, Department of Obstetrics and Gynecology, Sant\u2019Anna Hospital, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/S0140-6736(05)17987-2","article-title":"Pre-eclampsia","volume":"365","author":"Sibai","year":"2005","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Fox, R., Kitt, J., Leeson, P., Aye, C.Y.L., and Lewandowski, A.J. (2019). Preeclampsia: Risk factors, diagnosis, management, and the cardiovascular impact on the offspring. J. Clin. Med., 8.","DOI":"10.3390\/jcm8101625"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1080\/14767058.2018.1495191","article-title":"Preeclampsia and the challenge of early prediction: Reality or utopia? State of art and critical review of literature","volume":"33","author":"Capriglione","year":"2018","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_4","first-page":"17","article-title":"Pregnancy related mortalily surveillance\u2014United States, 1987\u20131990","volume":"46","author":"Koonin","year":"1997","journal-title":"Morb. Mortal. Wkly. Rep. CDC Surveill. Summ."},{"key":"ref_5","first-page":"2037","article-title":"Relationship between the pre-pregnancy BMI, gestational weight gain, and risk of preeclampsia and its subtypes","volume":"42","author":"Ren","year":"2021","journal-title":"Chin. J. Epidemiol."},{"key":"ref_6","unstructured":"Lindheimer, M.D., Roberts, J.M., and Cunningham, F.G. (1999). Platelet and coagulation abnormalities. Chesley\u2019s Hypertensive Disorders in Pregnancy, Appleton & Lange."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/S0002-9378(16)32330-4","article-title":"Syndrome of hemolysis, elevated liver enzymes, and low platelets count: A severe consequence of hypertension in pregnancy","volume":"142","author":"Weinstein","year":"1982","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_8","unstructured":"Scott, J.R., Di Saia, P.J., Hammond, C.B., and Spellacy, W.N. (1999). Danforth\u2019s Obstetrics & Gynecology, Lippincott Williams & Wilkins. [8th ed.]."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1111\/j.1471-0528.1999.tb08396.x","article-title":"Evaluation of a definition of preeclampsia","volume":"106","author":"North","year":"1999","journal-title":"Br. J. Obstet. Gynaecol."},{"key":"ref_10","first-page":"225","article-title":"Should the definition of preeclampsia include a rise in diastolic blood pressure=15 mm Hg?","volume":"182","author":"Levine","year":"2000","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1186\/s13643-022-01978-5","article-title":"Medications for preventing hypertensive disorders in high-risk pregnant women: A systematic review and network meta-analysis","volume":"11","author":"Liabsuetrakul","year":"2022","journal-title":"Syst. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.tjog.2017.08.004","article-title":"Preeclampsia: A review of the pathogenesis and possible management strategies based on its pathophysiological derangements","volume":"56","year":"2017","journal-title":"Taiwan J. Obstet. Gynecol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1016\/j.ajog.2005.10.813","article-title":"Preeclampsia, gestational hypertension and intrauterine growth restriction, related or independent conditions?","volume":"194","author":"Villar","year":"2006","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1016\/j.ajog.2005.10.819","article-title":"Recurrence of hypertensive disorder in second pregnancy","volume":"194","author":"Hjartardottir","year":"2006","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1016\/S0002-9378(00)70350-4","article-title":"Hypertensive disorders in twin versus singleton gestations","volume":"182","author":"Sibai","year":"2000","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1375\/twin.5.1.8","article-title":"Hypertensive disease in twin pregnancies. A review","volume":"5","author":"Krotz","year":"2002","journal-title":"Twin Res. Hum. Genet."},{"key":"ref_17","first-page":"1","article-title":"Births: Final data for 1999","volume":"49","author":"Ventura","year":"2001","journal-title":"Nat. Vital Stat. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1097\/HJH.0000000000003194","article-title":"Practical guide for the management of hypertensive disorders during pregnancy","volume":"40","author":"Antza","year":"2022","journal-title":"J. Hypertens."},{"key":"ref_19","first-page":"672","article-title":"Eklampsie","volume":"Volume 11","author":"Doderlein","year":"1916","journal-title":"Handbuch der Geburtshilfe"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1093\/oxfordjournals.aje.a010122","article-title":"Changing paternity and the risk of preeclampsia\/eclampsia in the subsequent pregnancy","volume":"151","author":"Li","year":"2000","journal-title":"Am. J. Epidemiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1097\/00001648-200111000-00008","article-title":"Higher risk of pre-eclampsia after change of partner. An effect of longer interpregnancy intervals?","volume":"12","author":"Basso","year":"2001","journal-title":"Epidemiology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1080\/14767050500361653","article-title":"Risk factors for preeclampsia in multiparous women: Primipaternity versus the birth interval hypothesis","volume":"19","author":"Deen","year":"2006","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1093\/aje\/kwg101","article-title":"Abortion, changed paternity, and risk of preeclampsia in nulliparous women","volume":"157","author":"Saftlas","year":"2003","journal-title":"Am. J. Epidemiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3143","DOI":"10.1001\/jama.1989.03430220066032","article-title":"An epidemiologic study of contraception and preeclampsia","volume":"262","author":"Savitz","year":"1989","journal-title":"JAMA"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Dahma, G., Neamtu, R., Nitu, R., Gluhovschi, A., Bratosin, F., Grigoras, M.L., Silaghi, C., Citu, C., Orlu, I.N., and Bhattarai, S. (2022). The influence of maternal vitamin D supplementation in pregnancies associated with preeclampsia: A case-control study. Nutrients, 14.","DOI":"10.3390\/nu14153008"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S333","DOI":"10.1016\/j.ajog.2021.11.559","article-title":"Human leukocyte antigen HLA-C, HLA-G, HLA-F and HLA-E placental profiles are altered in early severe preeclampsia and preterm birth with chorioamnionitis","volume":"226","author":"Dunk","year":"2022","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_27","first-page":"289","article-title":"Nulliparous preeclampsia (PE) is associated with placental expression of a variant allele of the new histocompatibility gene: HLA-G","volume":"170","author":"Main","year":"1994","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1002\/JLB.5RU1120-787RR","article-title":"Cellular immune responses in the pathophysiology of preeclampsia","volume":"111","author":"Miller","year":"2022","journal-title":"J. Leukoc. Biol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1016\/0002-9378(95)91324-6","article-title":"Underlying disorders associated with severe early-onset preeciampsia?","volume":"173","author":"Dekker","year":"1995","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Yang, Y., Wang, Y., Lv, Y., and Ding, H. (2022). Dissecting the roles of lipids in preeclampsia. Metabolites, 12.","DOI":"10.3390\/metabo12070590"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Abdelzaher, W.Y., Mostafa-Hedeab, G., Bahaa, H.A., Mahran, A., Atef Fawzy, M., Abdel Hafez, S.M.N., Welson, N.N., and Rofaeil, R.R. (2022). Leukotriene receptor antagonist, montelukast ameliorates L-Name-induced pre-eclampsia in rats through suppressing the IL-6\/Jak2\/STAT3 signaling pathway. Pharmaceuticals, 15.","DOI":"10.3390\/ph15080914"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1056\/NEJM200103223441201","article-title":"Paternal and matemai components of the predisposition to preeclampsia","volume":"344","author":"Esplin","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1136\/bmj.39540.522049.BE","article-title":"Accuracy of mean arterial pressure and blood pressure measurements in predicting pre-eclampsia: Systematic review and meta-analysis","volume":"336","author":"Cnossen","year":"2008","journal-title":"BMJ"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s40291-016-0245-9","article-title":"Cell-free fetal DNA for the prediction of pre-eclampsia at the first and second trimesters: A systematic review and meta-analysis","volume":"21","author":"Contro","year":"2017","journal-title":"Mol. Diagn. Ther."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1159\/000341264","article-title":"Competing risks model in early screening for preeclampsia by biophysical and biochemical markers","volume":"33","author":"Akolekar","year":"2013","journal-title":"Fetal Diagn. Ther."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.jogc.2017.08.047","article-title":"Does low PAPP-A predict advers placenta-mediated outcomes in a low-risk nulliparous population? The great obstetrical syndromes (GOS) study","volume":"40","author":"Boutin","year":"2017","journal-title":"J. Obstet. Gynaecol. Can."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1002\/uog.18816","article-title":"ASPRE trial: Performance of screening for preterm pre-eclampsia","volume":"50","author":"Rolnik","year":"2017","journal-title":"Ultrasound Obstet. Gynecol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/15\/4555\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:04:06Z","timestamp":1760141046000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/15\/4555"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,4]]},"references-count":37,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["jcm11154555"],"URL":"https:\/\/doi.org\/10.3390\/jcm11154555","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,4]]}}}