A prospective study of several potential biologic markers for early prediction of the development of preeclampsia.

Abstract

The purpose of this study was to prospectively evaluate the predictive performance of several potential biologic markers of preeclampsia used alone or in combination. A prospective cohort of 1366 nulliparous women was followed up longitudinally on three occasions during pregnancy. The predictive performance of the tests, used either alone or in combination (stepwise multiple logistic regression), was assessed and compared with that of the mean arterial pressure. Preeclampsia occurred in 109 of the pregnant women. At a specificity of 80% the sensitivity and the positive and negative predictive values for mean arterial pressure (at a threshold of 87 mm Hg) were 46.6%, 23.5%, and 92.0%, respectively, and the corresponding values for a multiple logistic model at 15 to 24 weeks that included some biologic markers, as well as the mean arterial pressure, were 57.1%, 26.9%, and 93.7%, respectively. Preeclampsia can be predicted by a combination of simple biologic tests with a performance similar to second-trimester mean arterial pressure. However, this procedure is insufficient in terms of clinical usefulness.