妊娠期复发性早发性高血压疾病的简单孕前预测规则。

Simple prepregnant prediction rule for recurrent early-onset hypertensive disease in pregnancy.

作者信息

Sep Simone J S, Smits Luc J M, Prins Martin H, Spaanderman Marc E A, Peeters Louis L H

机构信息

Department of Epidemiology, Maastricht University, PO Box 616, 6200 MD, Maastricht, Netherlands.

出版信息

Reprod Sci. 2009 Jan;16(1):80-7. doi: 10.1177/1933719108324889.

DOI:10.1177/1933719108324889

PMID:19144890

Abstract

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 <1% risk of recurrent early-onset disease.

CONCLUSIONS

The prediction rule identified, with clinically relevant predictive capacity, those women at very low risk for recurrent early-onset disease.

摘要

目的

我们旨在制定一种简单且对临床有用的预测规则，用于预测早发型复发性先兆子痫和/或HELLP综合征。

方法

纳入1996年至2007年间登记的既往有早发型先兆子痫和/或HELLP综合征且随后正在妊娠的妇女。通过逻辑回归分析评估孕前心血管、代谢、肾脏和凝血参数作为复发性疾病的潜在预测因素。

结果

186例下次妊娠中有16例（9%）复发早发型先兆子痫和/或HELLP综合征。预测模型包括高密度脂蛋白（mmol/L）和24小时尿总蛋白排泄量（mg/mmol肌酐）。受试者工作特征曲线下面积为0.77（95%置信区间：0.68 - 0.87）。预测敏感性和特异性分别为94%（69% - 99%）和53%（45% - 60%）。近50%的妇女可被归类为复发性早发型疾病风险<1%。