Simple Prepregnant Prediction Rule for Recurrent Early-onset Hypertensive Disease in Pregnancy

• Published in: Reproductive sciences (Thousand Oaks, Calif.) Calif.), 2009-01, Vol.16 (1), p.80-87
• Main Authors: Sep, Simone J.S., Smits, Luc J.M., Prins, Martin H., Spaanderman, Marc E.A., Peeters, Louis L.H.
• Format: Article
• Language: English
• Subjects: Adult; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Diseases of mother, fetus and pregnancy; Embryology; Female; Gynecology. Andrology. Obstetrics; HELLP Syndrome - diagnosis; Hematologic and hematopoietic diseases; Humans; Medical sciences; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Original Article; Platelet diseases and coagulopathies; Pre-Eclampsia - diagnosis; Predictive Value of Tests; Pregnancy; Pregnancy. Fetus. Placenta; Recurrence; Reproductive Medicine
• ISSN: 1933-7191; 1933-7205
• DOI: 10.1177/1933719108324889

Objective: We aimed to develop a simple clinically useful prediction rule for early-onset recurrent preeclampsia and/or HELLP syndrome. Methods: Women with previous early-onset preeclampsia and/or HELLP, enrolled between 1996 and 2007, and a subsequent ongoing pregnancy were included. Prepregnant cardiovascular, metabolic, renal, and clotting parameters were evaluated as potential predictors for recurrent disease by logistic regression analysis. Results: Early-onset preeclampsia and/or HELLP recurred in 16 (9%) of 186 next pregnancies. The prediction model included high-density lipoprotein (mmol/L) and 24-hour urinary total protein excretion (mg/mmol creatinine). The receiver operating characteristic area was 0.77 (95% confidence interval: 0.68-0.87). Predictive sensitivity and specificity were 94% (69%-99%) and 53% (45%-60%), respectively. Nearly 50% of the women could be classified as having