Maternal risk factors for hypertensive disorders in pregnancy: a multivariate approach

被引:0
作者
L C Y Poon
N A Kametas
T Chelemen
A Leal
K H Nicolaides
机构
[1] Harris Birthright Research Centre for Fetal Medicine,
[2] King's College Hospital,undefined
来源
Journal of Human Hypertension | 2010年 / 24卷
关键词
first-trimester screening; pregnancy; preeclampsia; gestational hypertension; maternal factors;
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学科分类号
摘要
The study aimed to develop prediction algorithms for hypertensive disorders based on multivariate analysis of factors from the maternal history and compare the estimated performance of such algorithms in the prediction of early preeclampsia (PE), late-PE and gestational hypertension (GH) with that recommended by the National Institute for Clinical Excellence (NICE). Logistic regression analysis was used to determine which of the maternal characteristics and history had significant contribution in predicting early-PE, late-PE and GH. There were 37 cases with early-PE, 128 with late-PE, 140 with GH and 8061 cases that were unaffected by PE or GH. Predictors of early-PE were Black race, chronic hypertension, prior PE and use of ovulation drugs. Predictors of late-PE and GH were increased maternal age and body mass index, and family history or history of PE. Additionally, late-PE was more common in Black, Indian and Pakistani women. The detection rates of early-PE, late-PE and GH in screening by maternal factors were 37.0, 28.9 and 20.7%, respectively, for a 5% false positive rate. Screening as suggested by NICE would have resulted in a false positive rate of 64.1% with detection rates of 89.2, 93.0 and 85.0% for early-PE, late-PE and GH, respectively. Meaningful screening for hypertensive disorders in pregnancy by maternal history necessitates the use of algorithms derived by logistic regression analysis.
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页码:104 / 110
页数:6
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  • [1] Moldenhauer JS(2002)ACOG practice bulletin: diagnosis and management of pre-eclampsia and eclampsia: number 33, January 2002 Obstet Gynecol 99 159-167
  • [2] Stanek J(2003)The frequency and severity of placental findings in women with pre-eclampsia are gestational age dependent Am J Obstet Gynecol 189 1173-1177
  • [3] Warshak C(2006)Morphometric placental villous and vascular abnormalities in early- and late-onset pre-eclampsia with and without fetal growth restriction BJOG 113 580-589
  • [4] Khoury J(2007)Uterine artery Doppler at 11 + 0 to 13 + 6 weeks in the prediction of pre-eclampsia Ultrasound Obstet Gynecol 30 742-749
  • [5] Sibai B(2008)Fetal Medicine Foundation Second-Trimester Screening Group. Prediction of pre-eclampsia by uterine artery Doppler imaging: relationship to gestational age at delivery and small-for-gestational age Ultrasound Obstet Gynecol 31 310-313
  • [6] Egbor M(2000)Predictors of neonatal outcome in women with severe pre-eclampsia or eclampsia between 24 and 33 weeks’ gestation Am J Obstet Gynecol 182 607-611
  • [7] Ansari T(2001)Long term mortality of mothers and fathers after pre-eclampsia: population based cohort study BMJ 323 1213-1217
  • [8] Morris N(1986)Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational age infants BJOG 93 1049-1059
  • [9] Green CJ(1998)UK multicentre project on assessment of risk of trisomy 21 by maternal age and fetal nuchal-translucency thickness at 10-14 weeks of gestation. Fetal Medicine Foundation First Trimester Screening Group Lancet 352 343-346
  • [10] Sibbons PD(2008)Screening for trisomy 21 by maternal age, fetal NT, free ß hCG and PAPP-A Ultrasound Obstet Gynecol 31 618-624