Abstract：
OBJECTIVE: To investigate the contribution of longitudinal mean arterial pressure (MAP) measurement during the first, second, and third trimesters of twin pregnancies to the prediction of pre-eclampsia.
METHODS: A retrospective cohort study was conducted on women with twin pregnancies. Historical data between 2019 and 2021 were analyzed, including maternal characteristics and mean artery pressure measurements were obtained at 11-13, 22-24, and 28-33 weeks of gestation. The outcome measures included pre-eclampsia with delivery <34 and ≥34 weeks of gestation. Models were developed using logistic regression, and predictive performance was evaluated using the area under the curve, detection rate at a given false-positive rate of 10%, and calibration plots. Internal validation was conducted via bootstrapping.
RESULTS: A total of 943 twin pregnancies, including 36 (3.82%) women who experienced early-onset pre-eclampsia and 93 (9.86%) who developed late-onset pre-eclampsia, were included in this study. To forecast pre-eclampsia during the third trimester, the most accurate prediction for early-onset pre-eclampsia resulted from a combination of maternal factors and MAP measured during this trimester. The optimal predictive model for late-onset pre-eclampsia includes maternal factors and MAP data collected during the second and third trimesters. The areas under the curve were 0.937 (95% confidence interval [CI] 0.894-0.981) and 0.887 (95% CI 0.852-0.921), respectively. The corresponding detection rates were 83.33% (95% CI 66.53%-93.04%) for early-onset pre-eclampsia and 68.82% (95% CI 58.26%-77.80%) for late-onset pre-eclampsia.
CONCLUSIONS: Repeated measurements of MAP during pregnancy significantly improved the accuracy of late-onset pre-eclampsia prediction in twin pregnancies. The integration of longitudinal data into pre-eclampsia screening may be an effective and valuable strategy.
METHODS: A retrospective cohort study was conducted on women with twin pregnancies. Historical data between 2019 and 2021 were analyzed, including maternal characteristics and mean artery pressure measurements were obtained at 11-13, 22-24, and 28-33 weeks of gestation. The outcome measures included pre-eclampsia with delivery <34 and ≥34 weeks of gestation. Models were developed using logistic regression, and predictive performance was evaluated using the area under the curve, detection rate at a given false-positive rate of 10%, and calibration plots. Internal validation was conducted via bootstrapping.
RESULTS: A total of 943 twin pregnancies, including 36 (3.82%) women who experienced early-onset pre-eclampsia and 93 (9.86%) who developed late-onset pre-eclampsia, were included in this study. To forecast pre-eclampsia during the third trimester, the most accurate prediction for early-onset pre-eclampsia resulted from a combination of maternal factors and MAP measured during this trimester. The optimal predictive model for late-onset pre-eclampsia includes maternal factors and MAP data collected during the second and third trimesters. The areas under the curve were 0.937 (95% confidence interval [CI] 0.894-0.981) and 0.887 (95% CI 0.852-0.921), respectively. The corresponding detection rates were 83.33% (95% CI 66.53%-93.04%) for early-onset pre-eclampsia and 68.82% (95% CI 58.26%-77.80%) for late-onset pre-eclampsia.
CONCLUSIONS: Repeated measurements of MAP during pregnancy significantly improved the accuracy of late-onset pre-eclampsia prediction in twin pregnancies. The integration of longitudinal data into pre-eclampsia screening may be an effective and valuable strategy.
摘要：
目的：为了研究纵向平均动脉压（MAP）测量在第一次，第二,双胎妊娠晚期预测先兆子痫。
方法：对双胎妊娠妇女进行回顾性队列研究。分析了2019年至2021年的历史数据，我们在妊娠11-13,22-24和28-33周时获得了包括母体特征和平均动脉压的测量结果.结局指标包括妊娠<34周和≥34周的先兆子痫。模型是使用逻辑回归开发的，并使用曲线下面积评估预测性能，在给定的假阳性率为10%时的检出率，和校准图。通过自举进行内部验证。
结果：共有943例双胎妊娠，包括36名(3.82%)出现早发型先兆子痫的妇女和93名(9.86%)出现晚发型先兆子痫的妇女,包括在这项研究中。预测妊娠晚期子痫前期，对早发型先兆子痫的最准确预测是在这三个月期间测量的母体因素和MAP的组合。迟发性先兆子痫的最佳预测模型包括在第二和第三三个月期间收集的母体因素和MAP数据。曲线下面积分别为0.937(95%置信区间[CI]0.894-0.981)和0.887(95%CI0.852-0.921),分别。早发型子痫前期检出率为83.33%(95%CI66.53%-93.04%),晚发型子痫前期检出率为68.82%(95%CI58.26%-77.80%)。
结论：妊娠期重复测量MAP可显著提高双胎妊娠晚发型子痫前期预测的准确性。将纵向数据整合到先兆子痫筛查中可能是一种有效且有价值的策略。
方法：对双胎妊娠妇女进行回顾性队列研究。分析了2019年至2021年的历史数据，我们在妊娠11-13,22-24和28-33周时获得了包括母体特征和平均动脉压的测量结果.结局指标包括妊娠<34周和≥34周的先兆子痫。模型是使用逻辑回归开发的，并使用曲线下面积评估预测性能，在给定的假阳性率为10%时的检出率，和校准图。通过自举进行内部验证。
结果：共有943例双胎妊娠，包括36名(3.82%)出现早发型先兆子痫的妇女和93名(9.86%)出现晚发型先兆子痫的妇女,包括在这项研究中。预测妊娠晚期子痫前期，对早发型先兆子痫的最准确预测是在这三个月期间测量的母体因素和MAP的组合。迟发性先兆子痫的最佳预测模型包括在第二和第三三个月期间收集的母体因素和MAP数据。曲线下面积分别为0.937(95%置信区间[CI]0.894-0.981)和0.887(95%CI0.852-0.921),分别。早发型子痫前期检出率为83.33%(95%CI66.53%-93.04%),晚发型子痫前期检出率为68.82%(95%CI58.26%-77.80%)。
结论：妊娠期重复测量MAP可显著提高双胎妊娠晚发型子痫前期预测的准确性。将纵向数据整合到先兆子痫筛查中可能是一种有效且有价值的策略。
