Predictive values of clinical parameters and biophysical and biochemical markers in the first trimester for the detection of small-for-gestational age fetuses.

OBJECTIVES: To evaluate the predictive values of maternal characteristics, biophysical parameters (mean arterial pressure [MAP] and Doppler uterine artery measurements), and biochemical parameters (pregnancy-associated plasma protein A [PAPP-A] and placental growth factor [PlGF]) alone and in association for small-for-gestational age (SGA) fetuses. METHODS: We performed a retrospective analysis of a prospective observational study that evaluated 615 pregnant women in the first trimester using ultrasonography. For all the women, information regarding clinical and obstetric histories, MAP, and uterine artery mean pulsatility index (UtA-PI), and blood samples for analysis of biochemical markers (PAPP-A and PlGF) were obtained. The patients were grouped according to birth weight as follows: group I (n=571), >10th percentile (control); group II (n=44), <10th percentile; and group III (n=34), <5th percentile. The predictive values of the variables for the detection of SGA fetuses were calculated using a logistic regression model and an analysis of the area under the receiver-operating characteristic curve (AUC). RESULTS: The sensitivity rates of the maternal characteristics, biophysical markers (MAP and UtA-PI), biochemical markers (PAPP-A and PlGF), and the association between them were: 23.3, 32.5, 25, and 30% respectively, at a false-positive (FP) rate of 10%, in group II and 26.5, 26.5, 23.5, and 23.5%, respectively, at a FP rate of 10% in group III. CONCLUSIONS: The predictive performances of the combination of maternal characteristics and biophysical and biochemical parameters were unsatisfactory, with a slight improvement in the predictive capacity for SGA fetuses <10th percentile.

Prediction of preeclampsia in the first trimester of pregnancy using maternal characteristics, mean arterial pressure, and uterine artery Doppler data in a Brazilian population.

OBJECTIVE: To evaluate the performance of the preeclampsia (PE) screening algorithm of the Fetal Medicine Foundation (FMF) during the first trimester in a Brazilian population using maternal characteristics, mean arterial pressure (MAP), and uterine artery Doppler data. METHODS: This is a prospective cohort study that evaluated 701 pregnant women during the first trimester ultrasound screening for chromosomal abnormalities (11-13+6 weeks). All patients provided information regarding clinical and obstetric history, MAP, and mean uterine artery pulsatility index (mean PI). Patients were assigned to four groups based on the presence of PE and gestational age at delivery: group 1 (control), patients without hypertensive disorders (n=571); group 2, PE and delivery before 34 weeks of gestation (n=7); group 3, PE and delivery before 37 weeks of gestation, including patients from group 2 and patients that presented PE with delivery between 34 and 37 weeks (n=17); and group 4, PE and delivery before 42 weeks of gestation, including patients from both groups 2 and 3 and patients that presented PE with delivery between 37 and 42 weeks of gestation (n=34). RESULTS: After the exclusion of 96 patients, we evaluated the data of 605 patients. By combining maternal characteristics, MAP, and the mean uterine artery PI for the detection of PE, we found a sensitivity of 71.4% in group 2, 50% in group 3, and 41.2% in group 4 (false positive rate=10%). CONCLUSION: Using maternal characteristics, MAP, and uterine artery Doppler data, we were able to identify a significant proportion of patients who developed preterm PE.

Reliability and dimensionality of the Short Alcohol Dependence Data (SADD) questionnaire in a clinical sample of hospitalized patients: using the SADD in a general hospital setting / Confiabilidade e dimensões do questionário Short Alcohol Dependence Data (SADD) em uma amostra de pacientes hospitalizados: uso do questionário SADD em hospital geral

OBJECTIVE: To assess the internal consistency and dimensionality of the Short Alcohol Dependence Data questionnaire in a general hospital sample. METHOD: A cross-sectional study was carried out involving 169 randomly selected inpatients of a general hospital in São Paulo, Brazil. A Portuguese version of the 15-item Short Alcohol Dependence Data questionnaire was applied together with a questionnaire to assess demographic and anthropometric data. RESULTS: The internal consistency of the Short Alcohol Dependence Data as measured using Cronbach's alpha was 0.79, indicating that the items of the questionnaire are related to the same construct. Principal Component Analysis of the scale resulted in a five-dimension solution accounting for 69.6 percent of the total variance. The mean score of the Short Alcohol Dependence Data in this sample was 7.96 (SD = 6.8). CONCLUSION: The adapted version of the SADD seems to retain the characteristics of the original version. The internal consistency of the instrument suggests that its questions converge to the same construct. The factorial solution reflects different dimensions that correspond to distinct aspects of the alcohol dependence syndrome.

OBJETIVO: Investigar a consistência interna e a dimensionalidade do questionário Short Alcohol Dependence Data utilizado em pacientes de um hospital geral. MÉTODO: Foi utilizada a versão de 15 questões do Short Alcohol Dependence Data em um estudo de corte transversal envolvendo 169 pacientes aleatoriamente selecionados internados em um hospital geral universitário em São Paulo, Brasil. RESULTADOS: A consistência interna do Short Alcohol Dependence Data medida pelo alfa de Cronbach foi 0,79, sugerindo que os itens do questionário convergem para um mesmo construto. A análise do componente principal da escala resultou em uma solução de cinco dimensões que explicam 69,6 por cento da variabilidade dos dados. A média das pontuações do Short Alcohol Dependence Data foi 7,97 (DP = 6,8). CONCLUSÃO: A versão adaptada do Short Alcohol Dependence Data parece manter as características do questionário original. A consistência interna elevada sugere que as questões convergem para um mesmo construto e a solução fatorial reflete a existência de distintas dimensões que correspondem aos diversos aspectos da síndrome de dependência do álcool.

Reliability and dimensionality of the Short Alcohol Dependence Data (SADD) questionnaire in a clinical sample of hospitalized patients: using the SADD in a general hospital setting.

OBJECTIVE: To assess the internal consistency and dimensionality of the Short Alcohol Dependence Data questionnaire in a general hospital sample. METHOD: A cross-sectional study was carried out involving 169 randomly selected inpatients of a general hospital in São Paulo, Brazil. A Portuguese version of the 15-item Short Alcohol Dependence Data questionnaire was applied together with a questionnaire to assess demographic and anthropometric data. RESULTS: The internal consistency of the Short Alcohol Dependence Data as measured using Cronbach's alpha was 0.79, indicating that the items of the questionnaire are related to the same construct. Principal Component Analysis of the scale resulted in a five-dimension solution accounting for 69.6% of the total variance. The mean score of the Short Alcohol Dependence Data in this sample was 7.96 (SD = 6.8). CONCLUSION: The adapted version of the SADD seems to retain the characteristics of the original version. The internal consistency of the instrument suggests that its questions converge to the same construct. The factorial solution reflects different dimensions that correspond to distinct aspects of the alcohol dependence syndrome.