Validation of Six Predictive Models for Adverse Outcomes of Hypertensive Disorders of Pregnancy in Eastern and Western China

SUN Fangcan; HAN Bing; GAO Yan; SHEN Minhong; CHEN Youguo; ZHONG Wen

doi:10.12290/xhyxzz.2021-0778

Volume 13 Issue 5

Sep. 2022

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Medical Journal of Peking Union Medical College Hospital > 2022 > 13(5): 837-844. > DOI: 10.12290/xhyxzz.2021-0778

SUN Fangcan, HAN Bing, GAO Yan, SHEN Minhong, CHEN Youguo, ZHONG Wen. Validation of Six Predictive Models for Adverse Outcomes of Hypertensive Disorders of Pregnancy in Eastern and Western China[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(5): 837-844. DOI: 10.12290/xhyxzz.2021-0778

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Validation of Six Predictive Models for Adverse Outcomes of Hypertensive Disorders of Pregnancy in Eastern and Western China

1.
The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China
2.
Department of Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu 610045, China

Funds:

Jiangsu Commission of Health Research Project H2019010

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Corresponding author:
HAN Bing, E-mail: hanbing@suda.edu.cn

GAO Yan, E-mail: 290475126@qq.com
Received Date: December 06, 2021
Accepted Date: January 24, 2022
Issue Publish Date: September 29, 2022

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Abstract

Abstract

Objective To explore the application value of six prediction models reported at home and abroad for adverse outcomes of hypertensive disorders of pregnancy(HDP) in eastern and western China.
Methods For all patients who delivered in the First Affiliated Hospital of Soochow University and Sichuan Provincial Maternal and Child Health Care Hospital from May 1, 2011 to April 30, 2019 and were diagnosed with HDP, their clinical data were retrospectively analyzed. Six models, fullPIERS, miniPIERS, Zwertbroek, PREP, Ngwenya, and Ma Guojun, were used to predict the risk of adverse outcomes for the patients. The predictive performance of the models was evaluated in terms of discrimination and calibration.
Results A total of 2978 patients were eligible. Combined adverse outcomes occurred in 13.6% (405/2978) of women within 48 h of admission, and 22.0% (655/2978) at any time during admission. The delivery < 34 weeks (49.4%, 200/405), need for blood product transfusion (43.5%, 176/405), and placental abruption (23.5%, 95/405) were the most common adverse outcomes within 48 hours of admission. The area under of the curve of the six models for predicting adverse outcomes in the patients with HDP within 48 hours of admission/during hospitalization ranged from 0.600 to 0.897, the sensitivity ranged from 57.1% to 69.5%, and the specificity ranged from 60.1% to 76.6%. The Hosmer-Lemeshow test showed that except for the PREP model (which had a small validation population and was not evaluated for calibration), the P-values of all the other 5 models were less than 0.05.
Conclusions The six prediction models have certain application value in the prediction of adverse outcomes of HDP patients in the eastern and western regions of China, but the fitting is poor. The predictors involved in some models are not routine inspection indicators, and the feasibility of large-scale model application is still open to question. It is still necessary to establish a better prognostic model suitable for local areas based on Chinese characteristics.
- hypertensive disorders of pregnancy,
- preeclampsia,
- adverse outcome,
- predictive model,
- China

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References

[1]	Agius A, Sultana R, Camenzuli C, et al. An update on the genetics of pre-eclampsia[J]. Minerva Ginecol, 2018, 70: 465-479.
[2]	Anon. ACOG Practice Bulletin No. 202: Gestational Hypertension and Preeclampsia[J]. Obstet Gynecol, 2019, 133: 1.
[3]	孙芳璨, 韩冰. 妊娠期高血压疾病不良结局预测模型的研究进展[J]. 实用妇产科杂志, 2019, 35: 677-681. https://www.cnki.com.cn/Article/CJFDTOTAL-SFCZ201909013.htm Sun FC, Han B. Advances in research on predictive models of adverse outcomes of pregnancy-induced hypertension[J]. Shiyong Fuchanke Zazhi, 2019, 35: 677-681. https://www.cnki.com.cn/Article/CJFDTOTAL-SFCZ201909013.htm
[4]	Tan J, Qi Y, Liu C, et al. The use of rigorous methods was strongly warranted among prognostic prediction models for obstetric care[J]. J Clin Epidemiol, 2019, 115: 98-105. DOI: 10.1016/j.jclinepi.2019.07.009
[5]	中华医学会妇产科学分会妊娠期高血压疾病学组. 妊娠期高血压疾病诊治指南(2020)[J]. 中华妇产科杂志, 2020, 55: 227-238. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSF201510002.htm Hypertensive Disorders in Pregnancy Subgroup, Chinese Society of Obstetrics and Gynecology, Chinese Medical Association. Diagnosis and treatment of hypertension and pre-eclampsia in pregnancy: a clinical practice guideline in China(2020)[J]. Zhonghua Fuchanke Zazhi, 2020, 55: 227-238. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSF201510002.htm
[6]	Chan P, Brown M, Simpson JM, et al. Proteinuria in preec-lampsia: how much matters?[J]. Bjog, 2005, 112: 280-285. DOI: 10.1111/j.1471-0528.2004.00395.x
[7]	Millman AL, Payne B, Qu Z, et al. Oxygen saturation as a predictor of adverse maternal outcomes in women with preeclampsia[J]. J Obstet Gynaecol Can, 2011, 33: 705-714. DOI: 10.1016/S1701-2163(16)34955-6
[8]	von Dadelszen P, Payne B, Li J, et al. Prediction of adverse maternal outcomes in pre-eclampsia: development and validation of the fullPIERS model[J]. Lancet, 2011, 377: 219-227. DOI: 10.1016/S0140-6736(10)61351-7
[9]	Payne BA, Hutcheon JA, Ansermino JM, et al. A risk prediction model for the assessment and triage of women with hypertensive disorders of pregnancy in low-resourced settings: the miniPIERS(Pre-eclampsia Integrated Estimate of RiSk) multi-country prospective cohort study[J]. PLoS Med, 2014, 11: e1001589. DOI: 10.1371/journal.pmed.1001589
[10]	Payne BA, Hutcheon JA, Dunsmuir D, et al. Assessing the incremental value of blood oxygen saturation(SpO₂) in the miniPIERS(Pre-eclampsia Integrated Estimate of RiSk) Risk Prediction Model[J]. J Obstet Gynaecol Can, 2015, 37: 16-24. DOI: 10.1016/S1701-2163(15)30358-3
[11]	Zwertbroek EF, Broekhuijsen K, Langenveld J, et al. Prediction of progression to severe disease in women with late preterm hypertensive disorders of pregnancy[J]. Acta Obstet Gynecol Scand, 2017, 96: 96-105. DOI: 10.1111/aogs.13051
[12]	Thangaratinam S, Allotey J, Marlin N, et al. Prediction of complications in early-onset pre-eclampsia(PREP): development and external multinational validation of prognostic models[J]. BMC Med, 2017, 15: 68. DOI: 10.1186/s12916-017-0827-3
[13]	廖媛, 刘兴会, 谭婧, 等. 建立子痫前期不良结局风险预警模型的初步研究[J]. 四川大学学报(医学版), 2018, 49: 797-802. https://www.cnki.com.cn/Article/CJFDTOTAL-HXYK201805023.htm Liao Y, Liu XH, Tan J, et al. Development of a predictive model for adverse outcomes of preeclampsia[J]. Sichuan Daxue Xuebao(Yixueban), 2018, 49: 797-802. https://www.cnki.com.cn/Article/CJFDTOTAL-HXYK201805023.htm
[14]	Chen R, Han Q, Zheng L, et al. Establishment and assessment of a nomogram for predicting adverse outcomes of preterm preeclampsia[J]. J Int Med Res, 2020, 48: 300060520911828.
[15]	Ngwenya S, Jones B, Mwembe D, et al. Development and validation of risk prediction models for adverse maternal and neonatal outcomes in severe preeclampsia in a low-resource setting, Mpilo Central Hospital, Bulawayo, Zimbabwe[J]. Pregnancy Hypertens, 2020, 23: 18-26.
[16]	Tan J, Yang M, Liao Y, et al. Development and validation of a prediction model on severe maternal outcomes among pregnant women with pre-eclampsia: a 10-year cohort study[J]. Sci Rep, 2020, 10: 15590. DOI: 10.1038/s41598-020-72527-0
[17]	马国珺, 庄旭, 邓东锐, 等. 重度子痫前期患者脏器损伤与不良妊娠结局相关性的多中心研究[J]. 实用妇产科杂志, 2020, 36: 443-447. https://www.cnki.com.cn/Article/CJFDTOTAL-SFCZ202006016.htm Ma GJ, Zhuang X, Deng DR, et al. The Correlation between Organ Function Impairment and Adverse Pregnancy Outcome in Patients with Severe Preeclampsia: a Multicenter Study[J]. Shiyong Fuchanke Zazhi, 2020, 36: 443-447. https://www.cnki.com.cn/Article/CJFDTOTAL-SFCZ202006016.htm
[18]	Ukah UV, Payne BA, Hutcheon JA, et al. Placental growth factor for the prognosis of women with preeclampsia(fullPIERS model extension): context matters[J]. BMC Pregnancy Childbirth, 2020, 20: 668. DOI: 10.1186/s12884-020-03332-w
[19]	Saleh L, Alblas MM, Nieboer D, et al. Prediction of pre-eclampsia-related complications in women with suspected or confirmed pre-eclampsia: development and internal validation of clinical prediction model[J]. Ultrasound Obstet Gynecol, 2021, 58: 698-704. DOI: 10.1002/uog.23142
[20]	沈敏红, 韩冰. fullPIERS预测模型用于574例妊娠高血压人群的初探[J]. 现代妇产科进展, 2012, 21: 172-174, 178. https://www.cnki.com.cn/Article/CJFDTOTAL-XDFC201203004.htm Shen MH, Han B. A preliminary study by using fulIPIERS model in adverse outcome prediction in 574 patients of pregnancy induced hypertension in China[J]. Xiandai Fuchanke Jinzhan, 2012, 21: 172-174, 178. https://www.cnki.com.cn/Article/CJFDTOTAL-XDFC201203004.htm
[21]	Heestermans T, Payne B, Kayode GA, et al. Prognostic models for adverse pregnancy outcomes in low-income and middle-income countries: a systematic review[J]. BMJ Glob Health, 2019, 4: e001759. DOI: 10.1136/bmjgh-2019-001759
[22]	Daru J, Zamora J, Fernández-Félix BM, et al. Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis[J]. Lancet Glob Health, 2018, 6: e548-e554.
[23]	Chappell LC, Brocklehurst P, Green ME, et al. Planned early delivery or expectant management for late preterm pre-eclampsia(PHOENIX): a randomised controlled trial[J]. Lancet, 2019, 394: 1181-1190.
[24]	Sinkey RG, Battarbee AN, Bello NA, et al. Prevention, Diagnosis, and Management of Hypertensive Disorders of Pregnancy: a Comparison of International Guidelines[J]. Curr Hypertens Rep, 2020, 22: 66.
[25]	Scott G, Gillon TE, Pels A, et al. Guidelines-similarities and dissimilarities: a systematic review of international clinical practice guidelines for pregnancy hypertension[J]. Am J Obstet Gynecol, 2022, 226: S1222-S1236.
[26]	Chaemsaithong P, Sahota DS, Poon LC. First trimester preeclampsia screening and prediction[J]. Am J Obstet Gynecol, 2022, 226: S1071-S1097. e2.
[27]	Lim S, Li W, Kemper J, et al. Biomarkers and the Prediction of Adverse Outcomes in Preeclampsia: A Systematic Review and Meta-analysis[J]. Obstet Gynecol, 2021, 137: 72-81.

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