Predictive Model for Preeclampsia Combining sFlt-1, PlGF, NT-proBNP, and Uric Acid as Biomarkers
Por:
Garrido-Giménez C., Cruz-Lemini M., Álvarez F.V., Nan M.N., Carretero F., Fernández-Oliva A., Mora J., Sánchez-García O., García-Osuna Á., Alijotas-Reig J., Llurba E.
Publicada:
5 ene 2023
Ahead of Print:
5 ene 2023
Resumen:
N-terminal pro-brain natriuretic peptide (NT-proBNP) and uric acid are elevated in pregnancies with preeclampsia (PE). Short-term prediction of PE using angiogenic factors has many false-positive results. Our objective was to validate a machine-learning model (MLM) to predict PE in patients with clinical suspicion, and evaluate if the model performed better than the sFlt-1/PlGF ratio alone. A multicentric cohort study of pregnancies with suspected PE between 24+0 and 36+6 weeks was used. The MLM included six predictors: gestational age, chronic hypertension, sFlt-1, PlGF, NT-proBNP, and uric acid. A total of 936 serum samples from 597 women were included. The PPV of the MLM for PE following 6 weeks was 83.1% (95% CI 78.5–88.2) compared to 72.8% (95% CI 67.4–78.4) for the sFlt-1/PlGF ratio. The specificity of the model was better; 94.9% vs. 91%, respectively. The AUC was significantly improved compared to the ratio alone [0.941 (95% CI 0.926–0.956) vs. 0.901 (95% CI 0.880–0.921), p < 0.05]. For prediction of preterm PE within 1 week, the AUC of the MLM was 0.954 (95% CI 0.937–0.968); significantly greater than the ratio alone [0.914 (95% CI 0.890–0.934), p < 0.01]. To conclude, an MLM combining the sFlt-1/PlGF ratio, NT-proBNP, and uric acid performs better to predict preterm PE compared to the sFlt-1/PlGF ratio alone, potentially increasing clinical precision. © 2023 by the authors.
Filiaciones:
Garrido-Giménez C.:
Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Antoni Maria Claret, 167, Barcelona, 08025, Spain
Women and Perinatal Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77–79, Barcelona, 08041, Spain
Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Network (SAMID-RICORS, RD21/0012), Maternal and Child Health Development Network (SAMID, RD16/0022), Instituto de Salud Carlos III, Madrid, 28040, Spain
Cruz-Lemini M.:
Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Antoni Maria Claret, 167, Barcelona, 08025, Spain
Women and Perinatal Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77–79, Barcelona, 08041, Spain
Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Network (SAMID-RICORS, RD21/0012), Maternal and Child Health Development Network (SAMID, RD16/0022), Instituto de Salud Carlos III, Madrid, 28040, Spain
Álvarez F.V.:
Clinical Biochemistry, Laboratory Medicine, Hospital Universitario Central de Asturias and Department of Biochemistry and Molecular Biology, Universidad de Oviedo, Oviedo, 33011, Spain
Nan M.N.:
Clinical Biochemistry, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, 08025, Spain
Carretero F.:
Clinical Biochemistry, Laboratory Medicine, Hospital Universitario Central de Asturias and Department of Biochemistry and Molecular Biology, Universidad de Oviedo, Oviedo, 33011, Spain
Cátedra de Inteligencia Analítica, Universidad de Oviedo, Oviedo, 33011, Spain
Fernández-Oliva A.:
Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Antoni Maria Claret, 167, Barcelona, 08025, Spain
Women and Perinatal Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77–79, Barcelona, 08041, Spain
Mora J.:
Clinical Biochemistry, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, 08025, Spain
Sánchez-García O.:
Women and Perinatal Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77–79, Barcelona, 08041, Spain
Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Network (SAMID-RICORS, RD21/0012), Maternal and Child Health Development Network (SAMID, RD16/0022), Instituto de Salud Carlos III, Madrid, 28040, Spain
García-Osuna Á.:
Clinical Biochemistry, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, 08025, Spain
Alijotas-Reig J.:
Systemic Autoimmune Disease Unit, Internal Medicine Department, Vall d’Hebron University Hospital, Departament de Medicina de la Universitat Autònoma de Barcelona, Barcelona, 08025, Spain
Systemic Autoimmune Diseases Research Group, Vall d’Hebron Research Institute/Vall d’Hebron Hospital, Barcelona, 08025, Spain
Llurba E.:
Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Antoni Maria Claret, 167, Barcelona, 08025, Spain
Women and Perinatal Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77–79, Barcelona, 08041, Spain
Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Network (SAMID-RICORS, RD21/0012), Maternal and Child Health Development Network (SAMID, RD16/0022), Instituto de Salud Carlos III, Madrid, 28040, Spain
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