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Objective <p>To evaluate associations between the first trimester SIMPLE nutritional score, early placental markers, and pregnancy outcome.</p> Methods <p>This is a longitudinal prospective multicenter observational cohort study recruiting healthy women with no comorbidities and singleton viable pregnancies undergoing first trimester prenatal screening. The SIMPLE nutritional score, biochemical (pregnancy-associated plasma protein A (PAPP-a), free ß-human chorionic gonadotropin (β-HCG)) and ultrasound (placental volume, uterine artery Doppler velocimetry) markers of placental function were collected at enrollment. Birth outcomes were collected at delivery. Main Outcome Measures: Multivariate generalized linear and logistic regression models were performed to investigate associations between SIMPLE score subgroups (&lt;6 versus ≥6) and items, placental markers, and pregnancy outcomes.</p> Results <p>Out of 2363 women enrolled, 325 were classified at high nutritional risk based on a first trimester SIMPLE score lower than 6. Multi-adjusted models showed that the SIMPLE score subgroup was significantly associated with first trimester PAPP-a concentrations (SIMPLE score ≥6 versus &lt;6: β = 0.047 (95% CI 0.004;0.089), <i>p</i> &lt; 0.05), as well as with the emergency cesarean section rates (SIMPLE score ≥6 versus &lt;6: aOR = 0.73 (95% CI −1.38;−0.07), <i>p</i> &lt; 0.05). The single item related to the first trimester hemoglobin concentrations higher than 110 g/L was significantly associated with early placental markers, birth (β = −116.2 (95% CI −213.6;18.7), <i>p</i> &lt; 0.05) and placental weights (β = −28.2 (95% CI −50.4;6.0), <i>p</i> &lt; 0.05) in multi-adjusted models.</p> Conclusions <p>The observed associations support the introduction of the SIMPLE score in clinical practice as a useful tool for predicting early placental development and pregnancy outcome.</p>

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Maternal first trimester SIMPLE nutritional score, early markers of placental function and pregnancy outcome: a prospective multicenter Italian study (SIMPLE study)

  • 期刊论文

  • 发表日期：

    2025年4月30日

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  • Francesca Parisi,
  • Chiara Coco,
  • Giovanna Esposito,
  • Stefano Guerriero,
  • Valeria Savasi,
  • Luca Marozio,
  • Felice Petraglia,
  • Arsenio Spinillo,
  • Maurizio Guida,
  • Giampiero Capobianco,
  • Nicoletta Di Simone,
  • Maddalena Morlando,
  • Rosario D’anna,
  • Luigi Nappi,
  • Irene Cetin,
  • Giorgia Boni,
  • Elisabetta Marelli,
  • Giulia Marchitelli,
  • Roberta Corneo,
  • Eleonora Fumagalli,
  • Michele Vignali,
  • Marinella Dell’Avanzo,
  • Lucia Pasquini,
  • Giulia Masini,
  • Sandro Gerli,
  • Irene Giardina,
  • Chiara Benedetto,
  • Annalisa Tancredi,
  • Fausta Benvenuti,
  • Camilla Berlingheri,
  • Pantaleo Greco,
  • Marco Palumbo,
  • Maria Giovanna Verzi,
  • Tommaso Simoncini,
  • Caterina Neri,
  • Antonio Lanzone,
  • Mariachiara Bosco,
  • Carlotta Tosadori,
  • Massimo Franchi,
  • Ettore Cicinelli,
  • Silvia Ajossa,
  • Camilla Desogus,
  • Stefano Angioni,
  • Maurizio N. D’Alterio,
  • Elena Silvestri,
  • Marco Petrillo,
  • Giuseppe Virdis,
  • Andrea Ciavattini

摘要

Objective

To evaluate associations between the first trimester SIMPLE nutritional score, early placental markers, and pregnancy outcome.

Methods

This is a longitudinal prospective multicenter observational cohort study recruiting healthy women with no comorbidities and singleton viable pregnancies undergoing first trimester prenatal screening. The SIMPLE nutritional score, biochemical (pregnancy-associated plasma protein A (PAPP-a), free ß-human chorionic gonadotropin (β-HCG)) and ultrasound (placental volume, uterine artery Doppler velocimetry) markers of placental function were collected at enrollment. Birth outcomes were collected at delivery. Main Outcome Measures: Multivariate generalized linear and logistic regression models were performed to investigate associations between SIMPLE score subgroups (<6 versus ≥6) and items, placental markers, and pregnancy outcomes.

Results

Out of 2363 women enrolled, 325 were classified at high nutritional risk based on a first trimester SIMPLE score lower than 6. Multi-adjusted models showed that the SIMPLE score subgroup was significantly associated with first trimester PAPP-a concentrations (SIMPLE score ≥6 versus <6: β = 0.047 (95% CI 0.004;0.089), p < 0.05), as well as with the emergency cesarean section rates (SIMPLE score ≥6 versus <6: aOR = 0.73 (95% CI −1.38;−0.07), p < 0.05). The single item related to the first trimester hemoglobin concentrations higher than 110 g/L was significantly associated with early placental markers, birth (β = −116.2 (95% CI −213.6;18.7), p < 0.05) and placental weights (β = −28.2 (95% CI −50.4;6.0), p < 0.05) in multi-adjusted models.

Conclusions

The observed associations support the introduction of the SIMPLE score in clinical practice as a useful tool for predicting early placental development and pregnancy outcome.