There has been interest in the use of first trimester maternal serum biomarkers to predict other adverse pregnancy outcomes.
Wandsworth Local Research Ethics Committee approval was in place for both the Doppler ultrasound before surgical termination and the use of first trimester tissue after the termination, and all women gave informed written consent.
Studies evaluating the use of first trimester maternal serum levels as predictors of complications in pregnancy have mostly relied on resource intensive methods such as prospective data collection or retrospective chart review.
In studies with concurrent use of first trimester uterine artery pulsatility index (UAPI), biochemical (PlGF or pregnancy associated plasma protein A) and arterial blood pressure (mean arterial or central augmentation index), there were good detection rate and discriminatory power between variants of hypertensive disorders (gestational hypertension, early and late pre-eclampsia) [ 22- 25].
What our probability plots suggest is that using combinations of second trimester amniotic fluid glucose and insulin would more reliably "rule out" GDM than diagnose it.
With the use of second-trimester ultrasonography, risk was increased by 69.4% of respondents and decreased by 33.1%.
In this respect, a particular strength of our study is its large sample size as well as its use of first-trimester serum, that is, ahead of PE diagnosis.
With the increased use of first-trimester screening for Down syndrome, there is the opportunity to 'piggy back' screening tests for preeclampsia, FGR and preterm delivery onto existing tests.
Stratified analyses by air conditioner use, season of first trimester, commute time, region, race/ethnicity, maternal age, smoking status, and employment status were performed to evaluate possible effect modification using the traffic metric (maximum traffic within 50 m) with the strongest association with SAB.
