Assessing FMF Pre-eclampsia Screening Efficiency

Predictive performance of the FMF pre-eclampsia screening algorithm is a vital tool for managing high-risk pregnancies, especially those conceived via assisted reproductive technology (ART). A prospective multicenter study in Denmark investigated the incidence of pre-eclampsia (PE) and the effectiveness of this algorithm across three distinct groups: ART, ovulation induction (OI), and spontaneous conception (SC). Consequently, the research highlights how the mode of conception significantly influences individual risk markers and overall detection accuracy.

Outcomes and Detection Rates by Conception Mode

The study involved 8,157 women and identified a significantly higher incidence of PE in the ART group (7.3%) compared to the SC group (3.4%). Furthermore, the incidence peaked at 12.3% for pregnancies resulting from oocyte donation (OD). Despite these epidemiological variations, the FMF pre-eclampsia screening algorithm maintained robust detection rates (DR) across all conception modes. Specifically, the DR for preterm PE reached 81.8% in the ART group, surpassing the 61.4% observed in spontaneous pregnancies. However, the screen-positive rate was markedly higher in ART pregnancies at 28.2%, compared to only 10% in the overall population.

Impact of Biomarkers and Clinical History

Certain biochemical and biophysical markers exhibited distinct patterns in pregnancies conceived through ART. Specifically, these patients demonstrated higher mean arterial pressure (MAP), higher uterine artery pulsatility index (UtA-PI), and lower placental growth factor (PlGF) levels. Because the algorithm integrates these specific markers, it accurately identifies increased risk but results in a larger proportion of ART patients being labeled screen-positive. Therefore, obstetricians should be prepared for more ART patients to require preventative clinical interventions, such as low-dose aspirin, based on these high-risk classifications.

FAQs

How does ART affect FMF pre-eclampsia screening results?

Pregnancies conceived via ART typically show higher screen-positive rates. This occurs because these patients often have altered biomarker levels, including higher mean arterial pressure and lower placental growth factor. Nevertheless, the algorithm remains a highly effective tool for identifying individuals at high risk for preterm pre-eclampsia.

Is the FMF algorithm reliable for oocyte donation?

Yes, the algorithm is reliable for oocyte donation cases. Although oocyte donation carries the highest risk for pre-eclampsia, the FMF tool effectively accounts for the maternal and biological factors associated with this conception mode to provide an accurate risk assessment.

Disclaimer: This content is for informational and educational purposes only. It does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.

References

Kjaer ASL et al. Predictive performance of Fetal Medicine Foundation first-trimester screening algorithm for pre-eclampsia according to conception mode. Ultrasound Obstet Gynecol. 2026 May 24. doi: 10.1002/uog.70244. PMID: 42177627.

Rolnik DL, et al. ASPRE trial: performance of screening for preterm pre-eclampsia. Ultrasound Obstet Gynecol. 2017;50(4):492-495.

Poon LC, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet. 2019;145 Suppl 1:1-33.