TY - JOUR
T1 - Prediction of Preeclampsia in Twins Using First Trimester
T2 - cffDNA Fraction, PlGF, and MAP
AU - Svirsky, Ran
AU - Sharabi-Nov, Adi
AU - Maymon, Ron
AU - Kugler, Nadav
AU - Landau Rabbi, Moran
AU - Brown, Richard
AU - Rodriguez, Heidy Portillo
AU - Peltier, Linda
AU - Nicolaides, Kypros
AU - Meiri, Hamutal
N1 - Publisher Copyright:
© 2025 The Author(s). Prenatal Diagnosis published by John Wiley & Sons Ltd.
PY - 2025/7
Y1 - 2025/7
N2 - Objectives: To evaluate cell-free fetal DNA fraction (cffDNAF) as a first-trimester screening marker for preeclampsia necessitating delivery before 37 weeks' gestation in twin pregnancies alone and combined with other bio-markers. Methods: Women with two live fetuses were enrolled in the first trimester, and evaluated for cffDNAF as a first trimester preeclampsia marker alone, and with placental growth factor (PlGF), mean arterial pressure (MAP), and uterine artery pulsatility index (UtA-PI). Results: There were 20 affected women; the cffDNAF was 9.0% (IQR: 8.4%–10.3%) in the affected, compared to 14% (IQR: 11%–16%) in 163 unaffected cases (p < 0.001). The AUROC for cffDNAF was 0.73 (95% CI: 0.61–0.85, p < 0.001), PlGF had an AUROC of 0.71 (0.59–0.83, p = 0.001), MAP had AUROC of 0.61 (0.50–0.72, p = 0.053) whereas UtA-PI had AUROC of 0.54 (0.39–0.69, p > 0.05). Combining all three biomarkers yielded an AUROC of 0.89 (0.78–0.98), with a sensitivity of 81%, specificity of 90%, negative predictive value (NPV) of 97.5%, and positive predictive value (PPV) of 50.7 UtA-PI did not contribute to the AUROC. Conclusion: In twin pregnancies low first trimester cffDNAF effectively screens for preeclampsia necessitating delivery before 37 weeks' gestation, which is augmented with PlGF and MAP.
AB - Objectives: To evaluate cell-free fetal DNA fraction (cffDNAF) as a first-trimester screening marker for preeclampsia necessitating delivery before 37 weeks' gestation in twin pregnancies alone and combined with other bio-markers. Methods: Women with two live fetuses were enrolled in the first trimester, and evaluated for cffDNAF as a first trimester preeclampsia marker alone, and with placental growth factor (PlGF), mean arterial pressure (MAP), and uterine artery pulsatility index (UtA-PI). Results: There were 20 affected women; the cffDNAF was 9.0% (IQR: 8.4%–10.3%) in the affected, compared to 14% (IQR: 11%–16%) in 163 unaffected cases (p < 0.001). The AUROC for cffDNAF was 0.73 (95% CI: 0.61–0.85, p < 0.001), PlGF had an AUROC of 0.71 (0.59–0.83, p = 0.001), MAP had AUROC of 0.61 (0.50–0.72, p = 0.053) whereas UtA-PI had AUROC of 0.54 (0.39–0.69, p > 0.05). Combining all three biomarkers yielded an AUROC of 0.89 (0.78–0.98), with a sensitivity of 81%, specificity of 90%, negative predictive value (NPV) of 97.5%, and positive predictive value (PPV) of 50.7 UtA-PI did not contribute to the AUROC. Conclusion: In twin pregnancies low first trimester cffDNAF effectively screens for preeclampsia necessitating delivery before 37 weeks' gestation, which is augmented with PlGF and MAP.
UR - https://www.scopus.com/pages/publications/105005782389
U2 - 10.1002/pd.6820
DO - 10.1002/pd.6820
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 40396999
AN - SCOPUS:105005782389
SN - 0197-3851
VL - 45
SP - 968
EP - 978
JO - Prenatal Diagnosis
JF - Prenatal Diagnosis
IS - 8
ER -