External validation and comparison of Fetal Medicine Foundation competing-risks model for small-for-gestational-age neonate in the first trimester : multicenter cohort study
Objectives: To examine the predictive performance of the Fetal Medicine Foundation (FMF) competing-risks model for the first-trimester prediction of a small-for-gestational-age (SGA) neonate in a large, independent, unselected European cohort and to compare the competing-risks algorithm with previou...
| Autores: | , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Universidad Francisco de Vitoria |
| Repositorio: | DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria |
| Idioma: | inglés |
| OAI Identifier: | oai:ddfv.ufv.es:10641/6899 |
| Acceso en línea: | https://hdl.handle.net/10641/6899 |
| Access Level: | acceso abierto |
| Palabra clave: | Bayes' theorem FMF Fetal Medicine Foundation SGA algorithm biomarker fetal growth restriction prediction model small-for-gestational age survival model Radiological and Ultrasound Technology Reproductive Medicine Radiology Nuclear Medicine and imaging Obstetrics and Gynecology Journal Article Multicenter Study Comparative Study Validation Study Research Support, Non-U.S. Gov't Yes yes |
| Sumario: | Objectives: To examine the predictive performance of the Fetal Medicine Foundation (FMF) competing-risks model for the first-trimester prediction of a small-for-gestational-age (SGA) neonate in a large, independent, unselected European cohort and to compare the competing-risks algorithm with previously published logistic-regression models. Methods: This was a retrospective, non-interventional, multicenter cohort study including 35 170 women with a singleton pregnancy who underwent a first-trimester ultrasound assessment between 11 + 0 and 13 + 6 weeks' gestation. We used the default FMF competing-risks model for the prediction of SGA combining maternal factors, uterine artery pulsatility index (UtA-PI), pregnancy-associated plasma protein-A (PAPP-A) and placental growth factor (PlGF) to obtain risks for different cut-offs of birth-weight percentile and gestational age at delivery. We examined the predictive performance in terms of discrimination and calibration and compared it with the published data on the model's development population and with published logistic-regression equations. Results: At a 10% false-positive rate, maternal factors and UtA-PI predicted 42.2% and 51.5% of SGA < 10th percentile delivered < 37 weeks and < 32 weeks, respectively. The respective values for SGA < 3rd percentile were 44.7% and 51.7%. Also at a 10% false-positive rate, maternal factors, UtA-PI and PAPP-A predicted 42.2% and 51.5% of SGA < 10th percentile delivered < 37 weeks and < 32 weeks, respectively. The respective values for SGA < 3rd percentile were 46.2% and 51.7%. At a 10% false-positive rate, maternal factors, UtA-PI, PAPP-A and PlGF predicted 47.6% and 66.7% of SGA < 10th percentile delivered < 37 weeks and < 32 weeks, respectively. The respective values for SGA < 3rd percentile were 50.0% and 69.0%. These data were similar to those reported in the original model's development study and substantially better than those calculated using pre-existing logistic-regression models (McNemar's test, P < 0.001). The FMF competing-risks model was well calibrated. Conclusions: The FMF competing-risks model for the first-trimester prediction of SGA is reproducible in an independent, unselected low-risk cohort and superior to logistic-regression approaches. |
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