Prediction of adverse maternal outcomes from pre-eclampsia and other hypertensive disorders of pregnancy: A systematic review

•Predicting maternal outcomes from HDPs could guide management of disorder.•We reviewed potential predictors of adverse maternal outcomes from HDPs.•Multivariable models performed better than individual tests.•Potentially useful tests include gestational age, chest pain, SpO2, and AST.•There is need...

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Bibliographic Details
Published in:Pregnancy hypertension 2018-01, Vol.11, p.115-123
Main Authors: Ukah, U. Vivian, De Silva, Dane A., Payne, Beth, Magee, Laura A., Hutcheon, Jennifer A., Brown, Helen, Ansermino, J. Mark, Lee, Tang, von Dadelszen, Peter
Format: Article
Language:English
Subjects:
Adult
Area Under Curve
Female
Humans
Hypertension, Pregnancy-Induced - diagnosis
Hypertension, Pregnancy-Induced - etiology
Hypertension, Pregnancy-Induced - mortality
Hypertensive disorders of pregnancy
Maternal complications
Maternal Mortality
Multivariate Analysis
Pre-eclampsia
Pre-Eclampsia - diagnosis
Pre-Eclampsia - etiology
Pre-Eclampsia - mortality
Prediction
Predictive Value of Tests
Pregnancy
Prognosis
Review
Risk Assessment
Risk Factors
ROC Curve
Young Adult
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Summary:•Predicting maternal outcomes from HDPs could guide management of disorder.•We reviewed potential predictors of adverse maternal outcomes from HDPs.•Multivariable models performed better than individual tests.•Potentially useful tests include gestational age, chest pain, SpO2, and AST.•There is need for better quality studies using standardized definitions of outcomes. The hypertensive disorders of pregnancy are a leading cause of maternal and perinatal mortality and morbidity. The ability to predict these complications using simple tests could aid in management and improve outcomes. We aimed to systematically review studies that reported on potential predictors of adverse maternal outcomes among women with a hypertensive disorder of pregnancy. We searched MEDLINE, Embase and CINAHL (inception – December 2016) for studies of predictors of severe maternal complications among women with a hypertensive disorder of pregnancy. Studies were selected in a two-stage process by two independent reviewers, excluding those reporting only on adverse fetal outcomes. We extracted data on study and test(s) characteristics and outcomes. Accuracy of prediction was assessed using sensitivity, specificity, likelihood ratios and area under the receiver operating curve (AUROC). Strong evidence of prediction was taken to be a positive likelihood ratio >10 or a negative likelihood ratio
ISSN:2210-7789
2210-7797
DOI:10.1016/j.preghy.2017.11.006