2026-04-05T12:41:49Zhttps://recercat.cat/oai/request
oai:recercat.cat:11351/90812025-10-01T01:32:17Zcom_2072_378071com_2072_378040col_2072_378097
RECERCAT author Cruz-Lemini, Mónica author Álvarez, Francisco V. author Nan, Madalina Nicoleta author Carretero, Francisco author Fernández-Oliva, Antonio author Alijotas Reig, Jaume author Garrido-Giménez, Carmen 2023-03-01T11:34:07Z2023-03-01T11:34:07Z2023-01-05 Angiogenic factors; Preeclampsia; Uric acidFactores angiogénicos; Preeclampsia; Ácido úricoFactors angiogènics; Preeclàmpsia; Àcid úricN-terminal pro-brain natriuretic peptide (NT-proBNP) and uric acid are elevated in pregnancies with preeclampsia (PE). Short-term prediction of PE using angiogenic factors has many false-positive results. Our objective was to validate a machine-learning model (MLM) to predict PE in patients with clinical suspicion, and evaluate if the model performed better than the sFlt-1/PlGF ratio alone. A multicentric cohort study of pregnancies with suspected PE between 24+0 and 36+6 weeks was used. The MLM included six predictors: gestational age, chronic hypertension, sFlt-1, PlGF, NT-proBNP, and uric acid. A total of 936 serum samples from 597 women were included. The PPV of the MLM for PE following 6 weeks was 83.1% (95% CI 78.5-88.2) compared to 72.8% (95% CI 67.4-78.4) for the sFlt-1/PlGF ratio. The specificity of the model was better; 94.9% vs. 91%, respectively. The AUC was significantly improved compared to the ratio alone [0.941 (95% CI 0.926-0.956) vs. 0.901 (95% CI 0.880-0.921), p < 0.05]. For prediction of preterm PE within 1 week, the AUC of the MLM was 0.954 (95% CI 0.937-0.968); significantly greater than the ratio alone [0.914 (95% CI 0.890-0.934), p < 0.01]. To conclude, an MLM combining the sFlt-1/PlGF ratio, NT-proBNP, and uric acid performs better to predict preterm PE compared to the sFlt-1/PlGF ratio alone, potentially increasing clinical precision.This work was supported by public funds obtained in competitive calls with peer review (grant PI19/00702), Insituto de Salud Carlos III, Spanish Ministry of Health, by the Maternal and Child Health and Development Network (SAMID, RD16/0022/0015), Instituto de Salud Carlos III, Madrid, Spain, the Spanish Clinical Research and Clinical Trials Platform, SCReN (Spanish Clinical Research Network), funded by the ISCIII-General Subdirectorate for Evaluation and Promotion of Research, through project PT13/0002/0028, integrated in the 2013–2016 R + D + I State Plan and co-financed by and the European Regional Development Fund (FEDER); and by the Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin Network (RICORS, RD21/0012/0001), Instituto de Salud Carlos III, Madrid, Spain, funded by the Recovery, Transformation and Resilience Plan 2017–2020, ISCIII, and by the European Union-Next Generation EU. Dr Cruz-Lemini is supported by Juan Rodés contract JR19/00047, Instituto de Salud Carlos III-Spanish Ministry of Health. Funding sources were not involved in study design, collection, analysis, and interpretation of data. Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess Marcadors bioquímics Àcid úric Preeclàmpsia - Diagnòstic CHEMICALS AND DRUGS::Heterocyclic Compounds::Alkaloids::Xanthines::Uric Acid CHEMICALS AND DRUGS::Biological Factors::Biomarkers DISEASES::Female Urogenital Diseases and Pregnancy Complications::Pregnancy Complications::Hypertension, Pregnancy-Induced::Pre-Eclampsia Other subheadings::Other subheadings::/diagnosis ENFERMEDADES::enfermedades de los genitales femeninos y complicaciones del embarazo::complicaciones del embarazo::hipertensión inducida en el embarazo::preeclampsia Otros calificadores::Otros calificadores::/diagnóstico COMPUESTOS QUÍMICOS Y DROGAS::compuestos heterocíclicos::alcaloides::xantinas::ácido úrico COMPUESTOS QUÍMICOS Y DROGAS::factores biológicos::biomarcadores Predictive Model for Preeclampsia Combining sFlt-1, PlGF, NT-proBNP, and Uric Acid as Biomarkers info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion