Conde-Agudelo A, Belizán J M, Lede R, Bergel E F
Centro Rosarino de Estudios Perinatales, Argentina.
Am J Obstet Gynecol. 1993 Sep;169(3):509-14. doi: 10.1016/0002-9378(93)90609-m.
The purpose of this study was to determine the predictive value of elevated mean arterial pressure in the second half of pregnancy for both preeclampsia and gestational hypertension.
This was a cohort of 588 nulliparous pregnant women studied prospectively from the twentieth week until delivery. Mean arterial pressure was obtained by means of a random-zero sphygmomanometer at 20, 26, and 31 weeks of gestation. The best cutoff point for the determination of predictive values was established by a receiver-operator characteristic curve.
Patterns of mean arterial pressure throughout pregnancy were different between preeclamptic and gestational hypertensive women. Receiver-operator characteristic curves for mean arterial pressure showed better predictive capacity for gestational hypertension than for preeclampsia. Sensitivity of mean arterial pressure to predict preeclampsia ranged between 39% and 48%, whereas for prediction of gestational hypertension it varied from 72% to 92%. Specificities for both groups were moderate (60% to 86%). Positive predictive values were low for all groups (5% to 33%).
Elevated mean arterial pressure in the second half of pregnancy is a good predictor of gestational hypertension but is a poor predictor of preeclampsia.
本研究旨在确定妊娠后半期平均动脉压升高对先兆子痫和妊娠期高血压的预测价值。
这是一项对588名初产妇进行的队列研究，前瞻性地从妊娠20周直至分娩。在妊娠20、26和31周时，使用随机零点血压计测量平均动脉压。通过受试者工作特征曲线确定预测值的最佳截断点。
先兆子痫和妊娠期高血压女性在整个孕期的平均动脉压模式不同。平均动脉压的受试者工作特征曲线显示，其对妊娠期高血压的预测能力比对先兆子痫的预测能力更好。平均动脉压预测先兆子痫的敏感性在39%至48%之间，而预测妊娠期高血压的敏感性则在72%至92%之间。两组的特异性中等（60%至86%）。所有组的阳性预测值都很低（5%至33%）。
妊娠后半期平均动脉压升高是妊娠期高血压的良好预测指标，但对先兆子痫的预测效果不佳。
