G.A. Dekker

Risk factors for infants small for gestational age by customised birthweight centiles: data from an international prospective cohort study

Please cite this paper as: McCowan L, Roberts C, Dekker G, Taylor R, Chan E, Kenny L, Baker P, Moss‐Morris R, Chappell L, North R on behalf of the SCOPE consortium. Risk factors for small‐for‐gestational‐age infants by customised birthweight centiles: data from an international prospective cohort study. BJOG 2010;117:1599–1607.

Changes in Doppler flow velocity waveforms and fetal size at 20 weeks gestation among cigarette smokers

Objectives  To compare umbilical and uterine artery Doppler waveforms and fetal size at 20 weeks between smokers and nonsmokers.

Antidepressant use in late gestation and risk of postpartum haemorrhage: a retrospective cohort study.

To investigate the association between antidepressant use in late gestation and postpartum haemorrhage (PPH).

Previous pregnancy loss has an adverse impact on distress and behaviour in subsequent pregnancy

To investigate whether women with previous miscarriages or terminations have higher levels of anxiety, depression, stress, and altered behaviours in a subsequent pregnancy.

An observational study of the impact of an antenatal asthma management service on asthma control during pregnancy

OBJECTIVE We sought to investigate the impact of introducing an antenatal asthma management service (AMS) on asthma control during pregnancy and subsequent perinatal outcomes. STUDY DESIGN Prospective, observational cohort study of pregnant asthmatic women attending a tertiary hospital antenatal clinic. Asthmatic women were recruited from the antenatal clinic and were followed prospectively with visits at 12, 20, 28 and 36 weeks gestation. A new nurse-led AMS was introduced offering asthma self-management education and support. Outcomes were compared between women recruited before and after the AMS was introduced (n=89 and 80, respectively) and included; prevalence of exacerbations during pregnancy, asthma control throughout pregnancy and perinatal outcomes, including preterm birth and small-for-gestational-age (SGA). RESULTS The relative risk for exacerbations (0.69; CI: 0.33-1.42), loss of control (0.67; CI 0.46-0.99) and persistent uncontrolled asthma (0.48; CI 0.26-0.9) were all reduced with attendance to AMS during pregnancy. AMS was associated with non-statistically significant reductions in asthma exacerbations (19.1-15.0%; p=0.480) and uncontrolled asthma at ≥ 2 study visits (21.3-11.3%; p=0.078). CONCLUSIONS These findings demonstrate the potential impact of an AMS in improving asthma control during pregnancy, supporting the need for an adequately powered RCT to determine its clinical- and cost-effectiveness.

Authors' Reply. Angiogenic factors combined with clinical risk factors to predict preterm pre-eclampsia in nulliparous women

Sir, The SCOPE consortium report (September 2013) on the plasma biomarkers placental growth factor, soluble fms-like tyrosine kinase-1 and endoglin early in pregnancy for predicting preterm pre-eclampsia is the climax of a huge piece of work. However, the SCOPE study registration site defined the planned primary outcome as pre-eclampsia ‘at any stage during pregnancy after recruitment until delivery or in the first 2 weeks after delivery’. It also defined a planned secondary outcome of ‘early onset pre-eclampsia’ defined as ‘pre-eclampsia resulting in delivery at <34 weeks’. Can the authors explain why the three tests’ predictions of neither of these were reported? Have they been reported elsewhere? Why was the tests’ prediction of a new outcome of ‘pre-eclampsia before 37 weeks’, which was not mentioned on the trial registry, reported instead?&

Prediction of the preterm preeclampsia in a prospective cohort of nulliparous women

Abstract T-330 for Poster Session: Preeclampsia: Angiogenesis, Endothelial Dysfunction (Thursday, 3/22/2012, 10:00 AM - 12:00 PM)Abstract T-287 for Poster Session: Polycystic Ovary Syndrome (Thursday, 3/22/2012, 10:00 AM - 12:00 PM)Abstract T-243 for Poster Session - Parturition: Hormones, Cytokines (Thursday, 3/22/2012, 10:00 AM - 12:00 PM)

Complications of Pregnancy and Future Cardiovascular Risk

The popular belief that “heart disease is a mans disease” is increasingly being proven to be a myth. Coronary heart disease (CHD) is a leading cause of morbidity and mortality among women and emerging evidence demonstrates that the prognosis for women after CHD is much worse than that for men. Pregnancy appears to be a physiological stress test that may identify women at risk of future CHD. Women who experience major complications of pregnancy have a twofold increased risk for later life CHD compared to women who have uncomplicated pregnancies. Postpartum follow-up after pregnancy complications may provide an ideal opportunity in primordial prevention of CHD.

PM.11 A Label-Free SRM Workflow Identifies a Subset of Pregnancy Specific Glycoproteins as Novel Predictive Markers of Early-Onset Pre-Eclampsia

Objective The aim of this study was to identify and verify plasma protein markers which may add to predictive algorithms for pre-eclampsia (PE) in asymptomatic nulliparous women. Methods We used a quantitative mass spectrometry (MS) approach to identify proteins with abundance changes in plasma (15 weeks) taken from women who subsequently develop PE recruited to the international SCOPE study. We developed a novel, targeted, label-free MS method, selective reaction monitoring (SRM) which enabled robust and reproducible verification of these proteins in a further 100 samples (16 early-onset PE, 42 late-onset PE, 42 controls). Results We identified and quantified >500 plasma proteins, and prioritised a set of candidate predictive markers. The two most promising, Platelet Basic Protein (PBP/NAP-2) and Pregnancy-specific glycoprotein (PSG)-9 were selected for further verification. The SRM method was validated extensively using dilution experiments for PSG proteins and by comparison to a commercial ELISA for NAP-2. NAP-2 was only elevated in a subset of women with PE, however, peptides unique to PSG-9 and PSG-5 were consistently elevated in women with subsequent early onset PE (p < 0.01; AUCs 0.72–0.75). Other PSG peptides were not different between groups. Conclusion This study has identified specific PSG proteins as being predictive of early-onset PE. Importantly, use of a highly specific MS method has enabled measurement of individual PSG family members which has not been possible using antibody-based techniques. Future work is needed to determine whether these proteins will improve current prediction algorithms for the identification of PE in low risk nulliparous women.

The use of crown rump length to predict small or large for gestational age and preterm birth

Abstract T-330 for Poster Session: Preeclampsia: Angiogenesis, Endothelial Dysfunction (Thursday, 3/22/2012, 10:00 AM - 12:00 PM)Abstract T-287 for Poster Session: Polycystic Ovary Syndrome (Thursday, 3/22/2012, 10:00 AM - 12:00 PM)Abstract T-243 for Poster Session - Parturition: Hormones, Cytokines (Thursday, 3/22/2012, 10:00 AM - 12:00 PM)