A PROSPECTIVE-STUDY OF SEVERAL POTENTIAL BIOLOGIC MARKERS FOR EARLY PREDICTION OF THE DEVELOPMENT OF PREECLAMPSIA

OBJECTIVE: The purpose of this study was to prospectively evaluate the predictive performance of several potential biologic markers of preec lampsia used alone or in combination. STUDY DESIGN: A prospective coho rt of 1366 nulliparous women was followed up longitudinally on three o ccasions during pregnancy. The predictive performance of the tests, us ed either alone or in combination (stepwise multiple logistic regressi on), was assessed and compared with that of the mean arterial pressure . RESULTS: Preeclampsia occurred in 109 of the pregnant women. At a sp ecificity of 80% the sensitivity and the positive and negative predict ive values for mean arterial pressure (at a threshold of 87 mm Hg) wer e 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 bio logic markers, as well as the mean arterial pressure, were 57.1%, 26.9 %, and 93.7%, respectively. CONCLUSION: Preeclampsia can be predicted by a combination of simple biologic tests with a performance similar t o second-trimester mean arterial pressure. However, this procedure is insufficient in terms of clinical usefulness.