Marcopito L F
Division of Epidemiology, Federal University of São Paulo, Brazil.
Sao Paulo Med J. 1997 Sep-Oct;115(5):1533-6. doi: 10.1590/s1516-31801997000500004.
To determine the roll-over test (ROT) performance in predicting pregnancy-induced hypertension (PIH) in primigravidae aged 15-29 years in a public primary care service.
Prospective cohort study enrolling 369 consecutive and initially normotensive primigravidae. The ROT was applied within 28-32 weeks of pregnancy. PIH was defined as diastolic blood pressure (DBP) 90 mm Hg or systolic blood pressure (SBP) 140 mm Hg, or a rise in DBP 15 mm Hg or a rise in SBP 30 mm Hg. The ROT prognostic properties were calculated, and a receiver operating characteristic (ROC) curve was constructed.
For the 20 mm Hg cutoff point, sensitivity was 20% and specificity was 93%. Positive and negative predictive values were, respectively, 23% and 92%, for a PIH cumulative incidence of 9.5%. With other cutoff points, the ROC curve showed a poor discriminatory value of the test.
The ROT was not useful for predicting PIH in a primary prenatal care setting.
在公共基层医疗服务中，确定翻转试验（ROT）对预测15 - 29岁初产妇妊娠高血压（PIH）的性能。
前瞻性队列研究，纳入369例连续且最初血压正常的初产妇。在妊娠28 - 32周内进行翻转试验。PIH定义为舒张压（DBP）≥90 mmHg或收缩压（SBP）≥140 mmHg，或DBP升高≥15 mmHg或SBP升高≥30 mmHg。计算翻转试验的预后特性，并构建受试者工作特征（ROC）曲线。
对于20 mmHg的截断点，敏感性为20%，特异性为93%。阳性和阴性预测值分别为23%和92%，PIH累积发病率为9.5%。对于其他截断点，ROC曲线显示该试验的鉴别价值较差。
在初级产前保健环境中，翻转试验对预测PIH无用。
