Perspectives, preferences and needs regarding early prediction of preeclampsia in Dutch pregnant women: a qualitative study

Crombag, Neeltje; Ruiter, Marije Lamain-de; Kwee, Anneke; Schielen, Peter C. J. I.; Bensing, J.M.; Visser, Gerard H.A.; Franx, Arie; Köster, Maria

doi:10.1186/s12884-016-1195-2

Cited by 16 publications

(18 citation statements)

References 35 publications

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“…Furthermore, a qualitative study was undertaken to explore pregnant women's perceptions, preferences and needs regarding prediction models for first-trimester screening for common pregnancy complications. 31 The final results of this study will be disseminated through regional obstetric collaboration associations, and will be made publicly accessible on the websites of collaborating partners. Development (project no.…”

Section: Discussionmentioning

confidence: 99%

“…A Dutch patient confederation for patients who had a pregnancy complicated by hypertensive disorders (HELLP foundation), was involved in defining the main research question and the design of the RESPECT study. Furthermore, a qualitative study was undertaken to explore pregnant women's perceptions, preferences and needs regarding prediction models for first‐trimester screening for common pregnancy complications 31 . The final results of this study will be disseminated through regional obstetric collaboration associations, and will be made publicly accessible on the websites of collaborating partners.…”

Section: Methodsmentioning

confidence: 99%

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Prognostic models versus single risk factor approach in first‐trimester selective screening for gestational diabetes mellitus: a prospective population‐based multicentre cohort study

Hoorn

Koster

Naaktgeboren

et al. 2020

BJOG

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Objectives To evaluate whether (1) first-trimester prognostic models for gestational diabetes mellitus (GDM) outperform the currently used single risk factor approach, and (2) a first-trimester random venous glucose measurement improves model performance. Design Prospective population-based multicentre cohort. Setting Thirty-one independent midwifery practices and six hospitals in the Netherlands. Population Women recruited before 14 weeks of gestation without pre-existing diabetes. Methods The single risk factor approach (presence of at least one risk factor: BMI ≥30 kg/m 2 , previous macrosomia, history of GDM, positive first-degree family history of diabetes, non-western ethnicity) was compared with the four best performing models in our previously published external validation study (

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Prognostic models versus single risk factor approach in first‐trimester selective screening for gestational diabetes mellitus: a prospective population‐based multicentre cohort study

Hoorn

Koster

Naaktgeboren

et al. 2020

BJOG

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“…Improved predictive and diagnostic tests can enable planned delivery, reducing maternal morbidity [17]. Similar to other studies, participants valued predictive and screening tests because of earlier access to care [18,19]. Support for informed decisions should include information about how such tests relate to better expectant management and improved pregnancy outcomes [20].…”

Section: Discussionmentioning

confidence: 78%

Women’s attitudes, beliefs and values about tests, and management for hypertensive disorders of pregnancy

Ahmed

Brewer

Tsigas

et al. 2021

BMC Pregnancy Childbirth

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Background Advances in research suggest the possibility of improving routine clinical care for preeclampsia using screening (predictive) and diagnostic tests. The views of women should be incorporated into the way in which such tests are used. Therefore, we explored the views of women with experience of preeclampsia and other hypertensive disorders in pregnancy (HDPs) about predictive and diagnostic tests, treatment risks, and expectant management. Method Eight hundred and seven women with experience of preeclampsia or other HDPs completed an online questionnaire. These women were participants in the Preeclampsia Registry (USA). The questionnaire contained 22 items to elicit women’s views about predictive tests (n = 8); diagnostic tests (n = 5); treatment risks (n = 7), and expectant management (n = 2). An optional text box allowed participants to add qualitative open-ended comments. Levels of agreement with the statements were reported descriptively for the sample as a whole, and a preliminary investigation of the role of lived experience in shaping women’s views was conducted by comparing subgroups within the sample based on time of HDP delivery (preterm/term). The qualitative data provided in the optional text box was analysed using inductive thematic analysis to examine participants’ responses. Results Women generally favored predictive and diagnostic testing, although not because they would opt for termination of pregnancy. Participants generally disagreed that taking daily low-dose aspirin (LDA) would make them nervous, with disagreement significantly higher in the preterm delivery subgroup. A high proportion of participants, especially in the preterm delivery subgroup, would take LDA throughout pregnancy. The majority of participants would be more worried about the possibility of preeclampsia than about the risks of treatments to their health (60%), and that proportion was significantly higher in the preterm delivery subgroup. There were no differences between subgroups in the views expressed about expectant management, although opinion was divided in both groups. Overall, most participants opted to put the baby’s interests first. Conclusion Women with experience of hypertensive disorders were enthusiastic about improved predictive and diagnostic tests. However, varied views about treatment options and expectant management suggest the need for a shared decision-making tool to enable healthcare professionals to support pregnant women’s decision-making to maximize the utility of these tests and interventions.

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“…While a formal cost‐benefit analysis is required, the lower FPR observed by adding PlGF MoM to the model would reduce costs of unnecessary monitoring and could justify the cost of addition of PlGF MoM to the algorithm. The lower FPR may also reduce anxiety associated with a positive test result …”

Section: Discussionmentioning

confidence: 99%

Prediction of preterm pre‐eclampsia at midpregnancy using a multivariable screening algorithm

Black

Rolnik

Al-Amin

et al. 2020

Aust NZ J Obst Gynaeco

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Background: Competing risk models used for midpregnancy prediction of preterm pre-eclampsia have shown detection rates (DR) of 85%, at fixed false-positive rate (FPR) of 10%. The full algorithm used between 19 +0 and 24 +6 weeks includes maternal factors, mean arterial pressure (MAP), mean uterine artery pulsatility index (UtAPI), serum placental growth factor (PlGF) level in multiples of the median (MoM), and soluble Fms-like tyrosine kinase-1 (sFlt-1) level in MoM. Aims: To assess performance of the Fetal Medicine Foundation (FMF) algorithm at midpregnancy to screen for preterm (<37 weeks) pre-eclampsia. The outcome measured was preterm pre-eclampsia. Materials and Methods: This is a prospective study including singleton pregnancies at 19-22 weeks gestation. Maternal bloods were collected and analysed using three different immunoassay platforms. Maternal characteristics, medical history, MAP, mean UtAPI, serum PlGF MoM and serum sFlt-1 MoM were used for risk assessment. DR and FPR were calculated, and receiver operating characteristic curves produced. Results: Five hundred and twelve patients were included. Incidence of preterm pre-eclampsia was 1.6%. Using predicted risk of pre-eclampsia of one in 60 or more and one in 100 or higher, as given by the FMF predictive algorithm, the combination with the best predictive performance for preterm pre-eclampsia included maternal factors, MAP, UtAPI and PlGF MoM, giving DRs of 100% and 100%, respectively, and FPRs of 9.3 for all platforms and 12.9-13.5, respectively. Addition of sFlt-1 to the algorithm did not appear to improve performance. sFlt-1 MoM and PlGF MoM values obtained on the different platforms performed very similarly. Conclusions: Second trimester combined screening for preterm pre-eclampsia by maternal history, MAP, mean UtAPI and PlGF MoM using the FMF algorithm performed very well in this patient population.

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Perspectives, preferences and needs regarding early prediction of preeclampsia in Dutch pregnant women: a qualitative study

Cited by 16 publications

References 35 publications

Prognostic models versus single risk factor approach in first‐trimester selective screening for gestational diabetes mellitus: a prospective population‐based multicentre cohort study

Prognostic models versus single risk factor approach in first‐trimester selective screening for gestational diabetes mellitus: a prospective population‐based multicentre cohort study

Women’s attitudes, beliefs and values about tests, and management for hypertensive disorders of pregnancy

Prediction of preterm pre‐eclampsia at midpregnancy using a multivariable screening algorithm

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