OP13.07: Evaluation of screening performance of first trimester competing risk prediction model for small for gestational age in Asian population

Le résumé fourni par la source

To examine the external validity of the new Fetal Medicine Foundation (FMF) competing risk model for the prediction of small for gestational age (SGA) at 11-14 weeks of gestation in Asian population. This is a multicentre prospective cohort study in 10,120 women with singleton pregnancies undergoing routine assessment at 11-14 weeks of gestation. We applied the FMF competing risk model for the first trimester prediction of SGA combining maternal characteristics and medical history with measurements of mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), and serum placental growth factor (PlGF). We obtained risks for different cut-offs of birthweight percentile. We examined the predictive performance in terms of discrimination and calibration. The predictive performance of the competing risk model for SGA was similar to that reported in the FMF study. Specifically, combining maternal factors with MAP, UtA-PI, and PlGF resulted in the best predictive performance for preterm SGA < 10th percentile and < 5th percentile, with area under the curves (AUCs) of 0.765 (95% confidence interval [CI], 0.720-0.809) and 0.789 (95% CI, 0.736-0.841), respectively. For predicting preterm SGA < 3rd percentile, the best model was the combination of maternal factors, MAP, and PlGF with an AUC of 0.797 (95% CI, 0.744-0.850). The calibration of the new model was satisfactory. The screening performance of the new FMF first trimester competing risk model for SGA in an independent large cohort of Asian women is comparable to that reported in the original FMF study on a mixed European population. This FMF SGA prediction model can be implemented as part of routine prenatal care by using existing healthcare infrastructure for pre-eclampsia screening.

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