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Using clinical symptoms to predict adverse maternal and perinatal outcomes in women with preeclampsia: data from the PIERS (Pre-eclampsia Integrated Estimate of RiSk) study.

TitleUsing clinical symptoms to predict adverse maternal and perinatal outcomes in women with preeclampsia: data from the PIERS (Pre-eclampsia Integrated Estimate of RiSk) study.
Publication TypeJournal Article
Year of Publication2011
AuthorsYen, T-W, Payne, BA, Qu, Z, Hutcheon, J, Lee, T, Magee, LA, Walters, BN, von Dadelszen, P
Corporate AuthorsPIERS (Pre-eclampsia Integrated Estimate of RiSk) Study Group
JournalJ Obstet Gynaecol Can
Volume33
Issue8
Pagination803-809
Date Published2011 Aug
ISSN1701-2163
KeywordsAdult, Cohort Studies, Female, Humans, PIERS, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Prognosis, Prospective Studies, Risk Factors, ROC Curve
Abstract

OBJECTIVES: Preeclampsia is a leading cause of maternal morbidity. The clinical challenge lies in predicting which women with preeclampsia will suffer adverse outcomes and would benefit from treatment, while minimizing potentially harmful interventions. Our aim was to determine the ability of maternal symptoms (i.e., severe nausea or vomiting, headache, visual disturbance, right upper quadrant pain or epigastric pain, abdominal pain or vaginal bleeding, and chest pain or dyspnea) to predict adverse maternal or perinatal outcomes.

METHODS: We used data from the PIERS (Pre-eclampsia Integrated Estimate of RiSk) study, a multicentre, prospective cohort study designed to investigate the maternal risks associated with preeclampsia. Relative risks and receiver operating characteristic (ROC) curves were assessed for each preeclampsia symptom and outcome pair.

RESULTS: Of 2023 women who underwent assessment, 52% experienced at least one preeclampsia symptom, with 5.2% and 5.3% respectively experiencing an adverse maternal or perinatal outcome. No symptom and outcome pair, in either of the maternal or perinatal groups, achieved an area under the ROC curve value > 0.7, which would be necessary to demonstrate a discriminatory predictive value.

CONCLUSION: Maternal symptoms of preeclampsia are not independently valid predictors of maternal adverse outcome. Caution should be used when making clinical decisions on the basis of symptoms alone in the preeclamptic patient.

DOI10.1016/S1701-2163(16)34983-0
Alternate JournalJ Obstet Gynaecol Can
Citation Key477
PubMed ID21846435
Grant List / / Canadian Institutes of Health Research / Canada