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First Trimester Prediction of Preeclampsia

  • Preeclampsia (VD Garovic, Section Editor)
  • Published:
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Abstract

Preeclampsia (PE) is a serious pregnancy-related condition that causes severe maternal and fetal morbidity and mortality. Within the recent years, there has been an increasing focus in predicting PE at the end of the first trimester of pregnancy. In this review, literature published between 2011 and 2015 was evaluated. In a total of six biomarker algorithms, for first and early second trimester, the prediction of preeclampsia is discussed. In addition, one randomized clinical trial was included. Several algorithms were based on placental biomarkers such as pregnancy-associated plasma protein A (PAPP-A), placental growth factor (PLGF), and soluble FMS-like tyrosine kinase 1 (s-FLT-1). The algorithms containing these biomarkers showed a high prediction rate (PR) for early onset PE, ranging from 44 to 92 % at 5 % false positive rate (FPR). New biomarkers suggest an alternative model based on free HbF and the heme scavenger alpha-1-microglobulin (A1M) with a prediction rate of 69 % at an FPR of 5 %. Interestingly, this model performs well without uterine artery Doppler pulsatility index (UtAD-PI), which is an advantage particularly if the screening method were to be implemented in developing countries. The randomized clinical trial showed a clear reduction in early onset PE as well as reducing preterm PE if identified high-risk pregnancies were treated with low-dose aspirin. In conclusion, PE prediction is now possible through several prediction algorithms and prophylaxis is beneficial in high-risk cases.

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Conflict of Interest

Drs. Åkerström and Hansson declare grants from Swedish Medical Research Council and A1M Pharma; they are board members and stock holders of A1M Pharma, have a grant pending from Swedish Medical Research Council, and have a patent pending for diagnosis of preeclampsia. Drs. Anderson and Gram have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Departments of Clinical Sciences Lund and Obstetrics and Gynecology, Lund University and Skåne University Hospital Malmö/Lund, Lund, Sweden

    Ulrik Dolberg Anderson & Stefan R. Hansson

  2. Departments of Clinical Sciences Lund, Infection Medicine, Lund University, Lund, Sweden

    Magnus Gram & Bo Åkerström

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  1. Ulrik Dolberg Anderson
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  2. Magnus Gram
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  3. Bo Åkerström
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  4. Stefan R. Hansson
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Correspondence to Ulrik Dolberg Anderson.

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This article is part of the Topical Collection on Preeclampsia

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Anderson, U.D., Gram, M., Åkerström, B. et al. First Trimester Prediction of Preeclampsia. Curr Hypertens Rep 17, 74 (2015). https://doi.org/10.1007/s11906-015-0584-7

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  • DOI: https://doi.org/10.1007/s11906-015-0584-7

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