Current CHS and NHBPEP criteria for severe preeclampsia do not uniformly predict adverse maternal or perinatal outcomes.
OBJECTIVE
To determine the association between adverse maternal/perinatal outcomes and Canadian and U.S. preeclampsia severity criteria.


METHODS
Using PIERS data (Preeclampsia Integrated Estimate of RiSk), an international continuous quality improvement project for women hospitalized with preeclampsia, we examined the association between preeclampsia severity criteria and adverse maternal and perinatal outcomes (univariable analysis, Fisher's exact test). Not evaluated were variables performed in <80% of pregnancies (e.g., 24-hour proteinuria).


RESULTS
Few of the evaluated variables were associated with adverse maternal (chest pain/dyspnea, thrombocytopenia, 'elevated liver enzymes', HELLP syndrome, and creatinine >110 microM) or perinatal outcomes (dBP >110 mm Hg and suspected abruption) (at p < 0.01).


CONCLUSIONS
In the PIERS cohort, most factors used in the Canadian or American classifications of severe preeclampsia do not predict adverse maternal and/or perinatal outcomes. Future classification systems should take this into account.
Menzies
J
J
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada.
Magee
L A
LA
Macnab
Y C
YC
Ansermino
J M
JM
Li
J
J
Douglas
M J
MJ
Gruslin
A
A
Kyle
P
P
Lee
S K
SK
Moore
M P
MP
Moutquin
J M
JM
Smith
G N
GN
Walker
J J
JJ
Walley
K R
KR
Russell
J A
JA
von Dadelszen
P
P
D000037:Abruptio Placentae / Q000145:classification; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D002170:Canada; D002637:Chest Pain / Q000145:classification; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D004417:Dyspnea / Q000145:classification; D005260:Female; D005315:Fetal Diseases / Q000145:classification; D005544:Forecasting; D017359:HELLP Syndrome / Q000145:classification; D006801:Humans; D007231:Infant, Newborn; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008099:Liver / Q000201:enzymology; D011225:Pre-Eclampsia / Q000145:classification*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018570:Risk Assessment; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000145:classification; D014481:United States
D003404:Creatinine; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase