TY - JOUR
T1 - First-trimester prediction of preterm birth using ADAM12, PAPP-A, uterine artery Doppler, and maternal characteristics
AU - Goetzinger, Katherine R.
AU - Cahill, Alison G.
AU - Kemna, Janet
AU - Odibo, Linda
AU - Macones, George A.
AU - Odibo, Anthony O.
PY - 2012/10
Y1 - 2012/10
N2 - Objective: The objective of this study was to estimate the efficiency of first-trimester a disintegrin and metalloprotease 12 (ADAM12), pregnancy-associated plasma protein A (PAPP-A), uterine artery Doppler, and maternal characteristics in the prediction of preterm birth (PTB). Methods: This was a prospective cohort study of patients presenting for first-trimester aneuploidy screening. Maternal serum ADAM12 and PAPP-A levels were measured by immunoassay, and mean uterine artery Doppler pulsatility indices were calculated. The primary outcome was PTB <34weeks' gestation, and the secondary outcome was PTB <37weeks' gestation. Logistic regression was used to model the prediction of PTB using ADAM12, PAPP-A, uterine artery Doppler, and maternal characteristics, individually and in combination. Sensitivity, specificity, and area under the receiver-operating characteristic curves were compared between models. Results: Of 578 patients, 36 (6.2%) delivered <34weeks, and 78 (13.5%) delivered <37weeks. For a 20% fixed false positive rate, ADAM12, PAPP-A, and uterine artery Doppler identified 58%, 52%, and 62% of patients with PTB <34weeks and 42%, 48%, and 50% of patients with PTB <37weeks, respectively. Combining these first-trimester parameters did not improve the predictive efficiency of the models. Conclusion: First-trimester ADAM12, PAPP-A, and uterine artery Doppler are each modestly predictive of PTB; however, combinations of these parameters do not further improve their screening efficiency.
AB - Objective: The objective of this study was to estimate the efficiency of first-trimester a disintegrin and metalloprotease 12 (ADAM12), pregnancy-associated plasma protein A (PAPP-A), uterine artery Doppler, and maternal characteristics in the prediction of preterm birth (PTB). Methods: This was a prospective cohort study of patients presenting for first-trimester aneuploidy screening. Maternal serum ADAM12 and PAPP-A levels were measured by immunoassay, and mean uterine artery Doppler pulsatility indices were calculated. The primary outcome was PTB <34weeks' gestation, and the secondary outcome was PTB <37weeks' gestation. Logistic regression was used to model the prediction of PTB using ADAM12, PAPP-A, uterine artery Doppler, and maternal characteristics, individually and in combination. Sensitivity, specificity, and area under the receiver-operating characteristic curves were compared between models. Results: Of 578 patients, 36 (6.2%) delivered <34weeks, and 78 (13.5%) delivered <37weeks. For a 20% fixed false positive rate, ADAM12, PAPP-A, and uterine artery Doppler identified 58%, 52%, and 62% of patients with PTB <34weeks and 42%, 48%, and 50% of patients with PTB <37weeks, respectively. Combining these first-trimester parameters did not improve the predictive efficiency of the models. Conclusion: First-trimester ADAM12, PAPP-A, and uterine artery Doppler are each modestly predictive of PTB; however, combinations of these parameters do not further improve their screening efficiency.
UR - http://www.scopus.com/inward/record.url?scp=84867002760&partnerID=8YFLogxK
U2 - 10.1002/pd.3949
DO - 10.1002/pd.3949
M3 - Article
C2 - 22847849
AN - SCOPUS:84867002760
SN - 0197-3851
VL - 32
SP - 1002
EP - 1007
JO - Prenatal Diagnosis
JF - Prenatal Diagnosis
IS - 10
ER -