Predicting Hypertensive Disease in the First Trimester of Pregnancy: Risk Models and Analysis of Serum D-dimer Levels Combined with Plasma Pregnancy-Associated Protein A, Free β-Subunit of Human Chorionic Gonadotropin, and Fetal Nuchal Translucency.

We aimed to investigate the predictive ability of serum levels of D-dimer (DD) in the first trimester for the occurrence of hypertensive disorders of pregnancy (HDP). In this retrospective, case-cohort study, we measured the levels of DD, plasma pregnancy-associated protein A (PAPP-A), and free β-su...

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Published in:BioMed Research International pp. 1 - 14
Main Authors: Chen, Yiming, Ning, Wenwen, Chu, Xuelian, Chen, Yijie, Gu, Linyuan, Xie, Zhen, Li, Liyao, Wen, Caihe, Wang, Xiaoying
Format: research tables/charts Journal Article
Published: Wiley-Blackwell 3/30/2022
Online Access:View this record in EBSCOhost
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      dt: 3/30/2022
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1155/2022/8264958
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        atl: Predicting Hypertensive Disease in the First Trimester of Pregnancy: Risk Models and Analysis of Serum D-dimer Levels Combined with Plasma Pregnancy-Associated Protein A, Free β-Subunit of Human Chorionic Gonadotropin, and Fetal Nuchal Translucency.
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          Chen, Yiming
          Ning, Wenwen
          Chu, Xuelian
          Chen, Yijie
          Gu, Linyuan
          Xie, Zhen
          Li, Liyao
          Wen, Caihe
          Wang, Xiaoying
        affil: Department of Prenatal Diagnosis and Screening Center, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, Zhejiang 310008, China
      sug:
        subj:
          Pregnancy Trimester, First
          Pregnancy-Induced Hypertension Diagnosis
          Risk Assessment
          Fibrin Fibrinogen Degradation Products Blood
          Gonadotropins, Chorionic Blood
          Nuchal Translucency Measurement
          Biological Markers
          Human
          Pregnancy
          Female
          Adult
          Pre-Eclampsia
          Retrospective Design
          Sensitivity and Specificity
          Descriptive Statistics
          Case Control Studies
          Confidence Intervals
          Adult: 19-44 years
          Female
      ab: We aimed to investigate the predictive ability of serum levels of D-dimer (DD) in the first trimester for the occurrence of hypertensive disorders of pregnancy (HDP). In this retrospective, case-cohort study, we measured the levels of DD, plasma pregnancy-associated protein A (PAPP-A), and free β-subunit of human chorionic gonadotropin (free β-hCG) and analyzed fetal nuchal translucency (NT) in 150 healthy gravidas, 126 cases of gestational hypertension (GH), 53 cases of preeclampsia (PE), and 41 cases with severe preeclampsia (SPE). Likelihood ratio models and risk models were built using single markers (DD, PAPP-A, free β-hCG, and NT) and combinations of those markers. Analyses showed that the levels of DD multiple of the median (MoM) in the GH, PE, and SPE groups were all significantly higher than those in the control group, with significant differences between groups ( χ 2 = 70.325 , P < 0.001). The area under curve (AUCs) for DD in the GH, PE, and SPE groups was 0.699, 0.784, and 0.893, respectively; the positive likelihood ratio (+LR) was 1.534, 1.804, and 2.941, respectively; and the negative likelihood ratio (-LR) was 0.022, 0.081, and 0, respectively. When the cut-off values of DD for the GH, PE, and SPE groups were 0.725, 0.815, and 0.945 MoM, respectively, the corresponding sensitivities were 0.992, 0.962, and 1.000, respectively. As gestational hypertension progressed, the levels of DD tended to increase gradually. The maternal serum level of DD in the first trimester had correlative and diagnostic value for HDP. The sensitivity and specificity of maternal serum levels of DD level in the first trimester for different types of HDP were significantly different; the best sensitivity and specificity were detected in the SPE group. First trimester DD level, combined with other biochemical markers, may improve our ability to diagnose HDP.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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