Development and evaluation of a nomogram for adverse outcomes of preeclampsia in Chinese pregnant women

Abstract

Objective Preeclampsia, the main cause of maternal and perinatal deaths, is associated with several maternal complications and adverse perinatal outcomes. Some prediction models are uesd to evaluate adverse pregnancy outcomes. However, some of the current prediction models are mainly carried out in developed countries, and many problems are still exist. We, thus, developed and validated a nomogram to predict the risk of adverse pregnancy outcomes of preeclampsia in Chinese pregnant women. Methods The clinical data of 720 pregnant women with preeclampsia in seven medical institutions in Chongqing from January 1, 2010, to December 31, 2020, were analyzed retrospectively. The patients were divided into two groups: 180 cases (25%) with adverse outcomes and 540 cases (75%) without adverse outcomes. The indicators were identified via univariate analysis. Logistic regression analysis was used to establish the prediction model, which was displayed by a nomogram. The performance of the nomogram was evaluated in terms of the area under the receiver operating characteristic (ROC) curve, calibration, and clinical utility. Results Univariate analysis showed that 24 indicators were significantly different (P < 0.05). Logistic regression analysis showed that gestational age, 24 h urine protein qualitative, and TT were significantly different (P < 0.05). The area under the ROC curve was 0.781 (95% CI 0.737–0.825) in training set and 0.777 (95% CI 0.689–0.865) in test set. The calibration curve of the nomogram showed good agreement between prediction and observation. The analysis of the clinical decision curve showed that the nomogram is of practical significance. Conclusion Our study identified gestational age, 24 h urine protein qualitative, and TT as risk factors for adverse outcomes of preeclampsia in pregnant women, and constructed a nomogram that can easily predict and evaluate the risk of adverse pregnancy outcomes in women with preeclampsia.

Prevalence, risk factors, and adverse perinatal outcomes in Chinese women with pre-eclampsia: a large retrospective cohort study

“…Lastly, we comprehensively analyzed the associations between PE and perinatal outcomes of singleton as well as twin pregnancies. We observed a signi cant correlation between PE in singleton pregnancies and adverse perinatal outcomes, including an increased risk of preterm birth, cesarean section, stillbirth, low birth weight, fetal distress, neonatal unit admission, and neonatal asphyxia, which were in accordance with the results of previous studies [8,9,19,53]. A similar signi cant correlation between PE in twin pregnancies and adverse perinatal outcomes, except for stillbirth and neonatal asphyxia, was also observed, which has rarely been reported.…”

Cuidado de enfermería en gestantes con síndrome de HELLP en el servicio de ginecología

“…9 Además, la preeclampsia asociada al síndrome de HELLP puede ocasionar daños al hígado, los riñones y el sistema de coagulación de la sangre y en casos más graves, puede ocurrir eclampsia, edema pulmonar, accidente cerebrovascular en la madre, mientras que en los fetos, aumenta la probabilidad de muerte, nacimiento prematuro y muy bajo peso al nacer, unido a complicaciones a largo plazo, como trastornos del neurodesarrollo, resistencia a la insulina, diabetes, enfermedad coronaria e hipertensión. 10 Adicionalmente, aunque es poco común, otra complicación que puede presentarse en la ruptura espontánea del hígado durante el embarazo/puerperio (REHP) como resultado de un episodio hipertensivo asociado con HELLP, el cual es causa de altas tasas de mortalidad. Estos autores señalaron que los factores de riesgo más importantes para la REHP fueron la preeclampsia y el síndrome HELLP y esto se manifestó con afectaciones del lóbulo derecho (70,9%) en mujeres gestantes, seguido de ambos lóbulos en un 22,1% y del lóbulo izquierdo en un 6,9%.…”

Thyroid-stimulating hormone and total bile acids can predict adverse pregnancy outcome among patients with gestational hypertension

“…Comparatively, in the study by Sun et al [29], insulin-like growth factor-1 and soluble Fms-like tyrosine kinase-1 individually showed AUCs of 0.880 and 0.805 for predicting adverse pregnancy outcome. Zheng et al [30] also developed a prediction model using a column-line graph, achieving AUCs of 0.781 and 0.777. These findings underscore the value of the joint assessment of various risk factors in the early detection for highrisk patients with gestational hypertension, aiding in clinical decision-making and formulating personalized treatment plans.…”