Abstract：
OBJECTIVE: To report the predictive performance for preterm birth (PTB) of the Fetal Medicine Foundation (FMF) triple test and National Institute for health and Care Excellence (NICE) guidelines used to screen for pre-eclampsia and examine the impact of aspirin in the prevention of PTB.
METHODS: Secondary analysis of data from the SPREE study and the ASPRE trial.
METHODS: Multicentre studies.
METHODS: In SPREE, women with singleton pregnancies had screening for preterm pre-eclampsia at 11-13 weeks of gestation by the FMF method and NICE guidelines. There were 16 451 pregnancies that resulted in delivery at ≥24 weeks of gestation and these data were used to derive the predictive performance for PTB of the two methods of screening. The results from the ASPRE trial were used to examine the effect of aspirin in the prevention of PTB in the population from SPREE.
METHODS: Comparison of performance of FMF method and NICE guidelines for pre-eclampsia in the prediction of PTB and use of aspirin in prevention of PTB.
METHODS: Spontaneous PTB (sPTB), iatrogenic PTB for pre-eclampsia (iPTB-PE) and iatrogenic PTB for reasons other than pre-eclampsia (iPTB-noPE).
RESULTS: Estimated incidence rates of sPTB, iPTB-PE and iPTB-noPE were 3.4%, 0.8% and 1.6%, respectively. The corresponding detection rates were 17%, 82% and 25% for the triple test and 12%, 39% and 19% for NICE guidelines, using the same overall screen positive rate of 10.2%. The estimated proportions prevented by aspirin were 14%, 65% and 0%, respectively.
CONCLUSIONS: Prediction of sPTB and iPTB-noPE by the triple test was poor and poorer by the NICE guidelines. Neither sPTB nor iPTB-noPE was reduced substantially by aspirin.
METHODS: Secondary analysis of data from the SPREE study and the ASPRE trial.
METHODS: Multicentre studies.
METHODS: In SPREE, women with singleton pregnancies had screening for preterm pre-eclampsia at 11-13 weeks of gestation by the FMF method and NICE guidelines. There were 16 451 pregnancies that resulted in delivery at ≥24 weeks of gestation and these data were used to derive the predictive performance for PTB of the two methods of screening. The results from the ASPRE trial were used to examine the effect of aspirin in the prevention of PTB in the population from SPREE.
METHODS: Comparison of performance of FMF method and NICE guidelines for pre-eclampsia in the prediction of PTB and use of aspirin in prevention of PTB.
METHODS: Spontaneous PTB (sPTB), iatrogenic PTB for pre-eclampsia (iPTB-PE) and iatrogenic PTB for reasons other than pre-eclampsia (iPTB-noPE).
RESULTS: Estimated incidence rates of sPTB, iPTB-PE and iPTB-noPE were 3.4%, 0.8% and 1.6%, respectively. The corresponding detection rates were 17%, 82% and 25% for the triple test and 12%, 39% and 19% for NICE guidelines, using the same overall screen positive rate of 10.2%. The estimated proportions prevented by aspirin were 14%, 65% and 0%, respectively.
CONCLUSIONS: Prediction of sPTB and iPTB-noPE by the triple test was poor and poorer by the NICE guidelines. Neither sPTB nor iPTB-noPE was reduced substantially by aspirin.
摘要：
目的：报告胎儿医学基金会（FMF）三重测试和美国国家健康与护理卓越研究所（NICE）指南用于筛查先兆子痫的早产（PTB）预测性能，并检查阿司匹林在预防PTB中的影响。
方法：对来自SPREE研究和ASPRE试验的数据进行二次分析。
方法：多中心研究。
方法：在SPREE中，根据FMF方法和NICE指南,单胎妊娠女性在妊娠11~13周时进行了早产先兆子痫筛查.有16451例妊娠导致妊娠≥24周分娩，这些数据用于得出两种筛查方法对PTB的预测性能。ASPRE试验的结果用于检查阿司匹林在SPREE人群中预防PTB的作用。
方法：比较FMF方法和NICE指南在预测PTB和使用阿司匹林预防PTB方面的表现。
方法：自发性PTB（sPTB），用于先兆子痫的医源性PTB(iPTB-PE)和除先兆子痫以外的原因的医源性PTB(iPTB-noPE)。
结果：sPTB的估计发病率，iPTB-PE和iPTB-noPE分别为3.4%，0.8%和1.6%,分别。相应的检出率为17%,三重测试的82%和25%和12%，39%和19%的NICE指南，使用相同的总体筛查阳性率为10.2%。阿司匹林预防的比例估计为14%，65%和0%，分别。
结论：NICE指南通过三重检验对sPTB和iPTB-noPE的预测较差且较差。阿司匹林不会显著降低sPTB和iPTB-noPE。
方法：对来自SPREE研究和ASPRE试验的数据进行二次分析。
方法：多中心研究。
方法：在SPREE中，根据FMF方法和NICE指南,单胎妊娠女性在妊娠11~13周时进行了早产先兆子痫筛查.有16451例妊娠导致妊娠≥24周分娩，这些数据用于得出两种筛查方法对PTB的预测性能。ASPRE试验的结果用于检查阿司匹林在SPREE人群中预防PTB的作用。
方法：比较FMF方法和NICE指南在预测PTB和使用阿司匹林预防PTB方面的表现。
方法：自发性PTB（sPTB），用于先兆子痫的医源性PTB(iPTB-PE)和除先兆子痫以外的原因的医源性PTB(iPTB-noPE)。
结果：sPTB的估计发病率，iPTB-PE和iPTB-noPE分别为3.4%，0.8%和1.6%,分别。相应的检出率为17%,三重测试的82%和25%和12%，39%和19%的NICE指南，使用相同的总体筛查阳性率为10.2%。阿司匹林预防的比例估计为14%，65%和0%，分别。
结论：NICE指南通过三重检验对sPTB和iPTB-noPE的预测较差且较差。阿司匹林不会显著降低sPTB和iPTB-noPE。
