Predictive Model for Preeclampsia Combining sFlt-1, PlGF, NT-proBNP, and Uric Acid as Biomarkers

N-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 cli...

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Detalles Bibliográficos
Autores: Garrido-Giménez, Carmen|||0000-0003-2180-1715, Cruz-Lemini, Monica|||0000-0002-6807-3578, Álvarez Menéndez, Francisco V.|||0000-0002-2553-5402, Nan, Madalina Nicoleta|||0009-0001-2794-447X, Carretero, Francisco, Fernández-Oliva, Antonio|||0000-0002-8610-2600, Mora Brugués, Josefina|||0000-0001-6777-5132, Sánchez García, Olga|||0000-0002-5279-440X, García Osuna, Álvaro|||0000-0002-6682-0226, Alijotas-Reig, Jaume|||0000-0002-9212-3619, Llurba, Elisa|||0000-0003-4048-6407
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:270866
Acceso en línea:https://ddd.uab.cat/record/270866
https://dx.doi.org/urn:doi:10.3390/jcm12020431
Access Level:acceso abierto
Palabra clave:Angiogenic factors
Machine-learning
N-terminal pro-brain natriuretic peptide (NT-proBNP)
Placental growth factor (PlGF)
Prediction
Preeclampsia
Soluble fms-like tyrosine kinase 1 (sFlt-1)
Uric acid
Descripción
Sumario:N-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.

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