BACKGROUND: This study was conducted to evaluate how the preeclampsia integrated estimate of risk (fullPIERS) model performs in the prediction of adverse maternal outcomes when the predictor variables are all obtained within 24-h of admission for preeclampsia. METHODS: A prospective cohort study on 323 women who fulfilled definite inclusion and exclusion criteria was conducted. Subjects were monitored for clinical symptoms of preeclampsia, biochemical parameters, and adverse maternal and neonatal outcomes. A risk prediction score was calculated using the fullPIERS calculator. Statistical analysis of rates and ratios was carried out by assessing χ (2) test and odds ratio. RESULTS: 18.3 % (n = 60) had adverse maternal outcome and 42.8 % (n = 138) had adverse fetal outcome, and 43 (13.35 %) had combined adverse maternal and perinatal outcome. Dyspnea, visual disturbances, epigastric pain, and [Formula: see text] appeared to be highly significant risk factors. In the biochemical variables studied, serum creatinine and serum uric acid were found to have a significant association. The association between adverse perinatal outcome and vaginal delivery was highly significant (OR 0.35, 95 % CI 0.19, 0.63), and the P value was 0.0005. The likelihood ratio associated with the highest risk group (predicted probability of the outcome ≥30 %) showed excellent performance (i.e., 17.5) of fullPIERS model as a rule in test. CONCLUSION: The fullPIERS model performed well in the prediction of adverse maternal outcomes in women with preeclampsia. It is easy to use. The model is based on the use of few important clinical and biochemical parameters and does not require extensive laboratory testing. Although it might be of limited use in a well-equipped tertiary care facility, this model can be utilized in the setting of district or sub-district level hospitals to identify patients who are at risk of complications due to preeclampsia. Timely referral to a higher center will help in reducing the morbidity and mortality associated with this condition.
BACKGROUND: This study was conducted to evaluate how the preeclampsia integrated estimate of risk (fullPIERS) model performs in the prediction of adverse maternal outcomes when the predictor variables are all obtained within 24-h of admission for preeclampsia. METHODS: A prospective cohort study on 323 women who fulfilled definite inclusion and exclusion criteria was conducted. Subjects were monitored for clinical symptoms of preeclampsia, biochemical parameters, and adverse maternal and neonatal outcomes. A risk prediction score was calculated using the fullPIERS calculator. Statistical analysis of rates and ratios was carried out by assessing χ (2) test and odds ratio. RESULTS: 18.3 % (n = 60) had adverse maternal outcome and 42.8 % (n = 138) had adverse fetal outcome, and 43 (13.35 %) had combined adverse maternal and perinatal outcome. Dyspnea, visual disturbances, epigastric pain, and [Formula: see text] appeared to be highly significant risk factors. In the biochemical variables studied, serum creatinine and serum uric acid were found to have a significant association. The association between adverse perinatal outcome and vaginal delivery was highly significant (OR 0.35, 95 % CI 0.19, 0.63), and the P value was 0.0005. The likelihood ratio associated with the highest risk group (predicted probability of the outcome ≥30 %) showed excellent performance (i.e., 17.5) of fullPIERS model as a rule in test. CONCLUSION: The fullPIERS model performed well in the prediction of adverse maternal outcomes in women with preeclampsia. It is easy to use. The model is based on the use of few important clinical and biochemical parameters and does not require extensive laboratory testing. Although it might be of limited use in a well-equipped tertiary care facility, this model can be utilized in the setting of district or sub-district level hospitals to identify patients who are at risk of complications due to preeclampsia. Timely referral to a higher center will help in reducing the morbidity and mortality associated with this condition.
Authors: Peter von Dadelszen; Beth Payne; Jing Li; J Mark Ansermino; Fiona Broughton Pipkin; Anne-Marie Côté; M Joanne Douglas; Andrée Gruslin; Jennifer A Hutcheon; K S Joseph; Phillipa M Kyle; Tang Lee; Pamela Loughna; Jennifer M Menzies; Mario Merialdi; Alexandra L Millman; M Peter Moore; Jean-Marie Moutquin; Annie B Ouellet; Graeme N Smith; James J Walker; Keith R Walley; Barry N Walters; Mariana Widmer; Shoo K Lee; James A Russell; Laura A Magee Journal: Lancet Date: 2010-12-23 Impact factor: 79.321
Authors: J Menzies; L A Magee; Y C Macnab; J M Ansermino; J Li; M J Douglas; A Gruslin; P Kyle; S K Lee; M P Moore; J M Moutquin; G N Smith; J J Walker; K R Walley; J A Russell; P von Dadelszen Journal: Hypertens Pregnancy Date: 2007 Impact factor: 2.108
Authors: Mark C Alanis; Christopher J Robinson; Thomas C Hulsey; Myla Ebeling; Donna D Johnson Journal: Am J Obstet Gynecol Date: 2008-09 Impact factor: 8.661
Authors: Shakila Thangaratinam; Ioannis D Gallos; Neki Meah; Sa'ada Usman; Khaled M K Ismail; Khalid S Khan Journal: Acta Obstet Gynecol Scand Date: 2011-04-15 Impact factor: 3.636
Authors: Tin-Wing Yen; Beth Payne; Ziguang Qu; Jennifer A Hutcheon; Tang Lee; Laura A Magee; Barry N Walters; Peter von Dadelszen Journal: J Obstet Gynaecol Can Date: 2011-08
Authors: Corine M Koopmans; Denise Bijlenga; Henk Groen; Sylvia Mc Vijgen; Jan G Aarnoudse; Dick J Bekedam; Paul P van den Berg; Karin de Boer; Jan M Burggraaff; Kitty Wm Bloemenkamp; Addy P Drogtrop; Arie Franx; Christianne Jm de Groot; Anjoke Jm Huisjes; Anneke Kwee; Aren J van Loon; Annemiek Lub; Dimitri Nm Papatsonis; Joris Am van der Post; Frans Jme Roumen; Hubertina Cj Scheepers; Christine Willekes; Ben Wj Mol; Maria G van Pampus Journal: Lancet Date: 2009-08-03 Impact factor: 79.321
Authors: Shakila Thangaratinam; Arri Coomarasamy; Fidelma O'Mahony; Steve Sharp; Javier Zamora; Khalid S Khan; Khaled M K Ismail Journal: BMC Med Date: 2009-03-24 Impact factor: 8.775
Authors: Shobhana Nagraj; Stephen H Kennedy; Robyn Norton; Vivekananda Jha; Devarsetty Praveen; Lisa Hinton; Jane E Hirst Journal: Front Cardiovasc Med Date: 2020-03-20