Beth A Payne1, Jennifer A Hutcheon1, Dustin Dunsmuir2, Garth Cloete3, Guy Dumont4, David Hall5, Joanne Lim2, Laura A Magee6, Rozina Sikandar7, Rahat Qureshi7, Erika van Papendorp5, J Mark Ansermino2, Peter von Dadelszen1. 1. Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; Child and Family Research Institute, Vancouver BC. 2. Child and Family Research Institute, Vancouver BC; Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver BC. 3. Department of Engineering Stellenbosch University, Stellenbosch, South Africa. 4. Child and Family Research Institute, Vancouver BC; Department of Electrical and Computer Engineering, University of British Columbia, Vancouver BC. 5. Department of Obstetrics and Gynaecology, Stellenbosch University, Stellenbosch, South Africa. 6. Child and Family Research Institute, Vancouver BC; Department of Medicine, University of British Columbia, Vancouver BC. 7. Department of Obstetrics and Gynaecology, Aga Khan University, Karachi, Pakistan.
Abstract
OBJECTIVE: To assess the incremental value of blood oxygen saturation (SpO(2)) as a predictor in the miniPIERS model, a risk prediction model for adverse outcomes among women with a diagnosis of hypertensive disorder of pregnancy (HDP) in low-resourced settings. METHODS: Using data from a prospective cohort including 852 women admitted to hospital for a HDP, the association between SpO(2) and adverse maternal outcome was assessed using logistic regression. The miniPIERS model was recalibrated and extended to include SpO(2). The incremental value of adding SpO(2) to the model was measured using a net reclassification index (NRI), sensitivity, specificity, positive and negative predictive values, and likelihood ratios. RESULTS: SpO(2) of < 93% was associated with a 30-fold increase in risk (95% CI 14 to 68) of adverse maternal outcome compared to women with SpO(2) > 97%. After recalibration and extension, the miniPIERS model including SpO(2) (vs. not including SpO(2)) had improved sensitivity (32.8% vs. 49.6%) at the cost of minimally decreased specificity (91.5% vs. 96.2%) with a NRI of 0.122. CONCLUSION: SpO(2) is a significant independent predictor of risk in women with a HDP. Adding SpO(2) to the miniPIERS model improved the model's ability to correctly identify high-risk patients who would benefit most from interventions.
OBJECTIVE: To assess the incremental value of blood oxygen saturation (SpO(2)) as a predictor in the miniPIERS model, a risk prediction model for adverse outcomes among women with a diagnosis of hypertensive disorder of pregnancy (HDP) in low-resourced settings. METHODS: Using data from a prospective cohort including 852 women admitted to hospital for a HDP, the association between SpO(2) and adverse maternal outcome was assessed using logistic regression. The miniPIERS model was recalibrated and extended to include SpO(2). The incremental value of adding SpO(2) to the model was measured using a net reclassification index (NRI), sensitivity, specificity, positive and negative predictive values, and likelihood ratios. RESULTS: SpO(2) of < 93% was associated with a 30-fold increase in risk (95% CI 14 to 68) of adverse maternal outcome compared to women with SpO(2) > 97%. After recalibration and extension, the miniPIERS model including SpO(2) (vs. not including SpO(2)) had improved sensitivity (32.8% vs. 49.6%) at the cost of minimally decreased specificity (91.5% vs. 96.2%) with a NRI of 0.122. CONCLUSION: SpO(2) is a significant independent predictor of risk in women with a HDP. Adding SpO(2) to the miniPIERS model improved the model's ability to correctly identify high-risk patients who would benefit most from interventions.
Authors: Joanne Lim; Garth Cloete; Dustin T Dunsmuir; Beth A Payne; Cornie Scheffer; Peter von Dadelszen; Guy A Dumont; J Mark Ansermino Journal: JMIR Mhealth Uhealth Date: 2015-04-17 Impact factor: 4.773
Authors: Laura A Magee; Sumedha Sharma; Hannah L Nathan; Olalekan O Adetoro; Mrutynjaya B Bellad; Shivaprasad Goudar; Salécio E Macuacua; Ashalata Mallapur; Rahat Qureshi; Esperança Sevene; John Sotunsa; Anifa Valá; Tang Lee; Beth A Payne; Marianne Vidler; Andrew H Shennan; Zulfiqar A Bhutta; Peter von Dadelszen Journal: PLoS Med Date: 2019-04-12 Impact factor: 11.069
Authors: Peter von Dadelszen; Meriel Flint-O'Kane; Lucilla Poston; Rachel Craik; Donna Russell; Rachel M Tribe; Umberto d'Alessandro; Anna Roca; Hawanatu Jah; Marleen Temmerman; Angela Koech Etyang; Esperança Sevene; Paulo Chin; Joy E Lawn; Hannah Blencowe; Jane Sandall; Tatiana T Salisbury; Benjamin Barratt; Andrew H Shennan; Prestige Tatenda Makanga; Laura A Magee Journal: Reprod Health Date: 2020-04-30 Impact factor: 3.223
Authors: U Vivian Ukah; Beth A Payne; Jennifer A Hutcheon; Lucy C Chappell; Paul T Seed; Frances Inez Conti-Ramsden; J Mark Ansermino; Laura A Magee; Peter von Dadelszen Journal: BMC Pregnancy Childbirth Date: 2020-11-05 Impact factor: 3.007