Simple prepregnant prediction rule for recurrent early-onset hypertensive disease in pregnancy.
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.
Sep
Simone J S
SJ
Department of Epidemiology, Maastricht University, PO Box 616, 6200 MD, Maastricht, Netherlands. simone.sep@og.unimaas.nl
Smits
Luc J M
LJ
Prins
Martin H
MH
Spaanderman
Marc E A
ME
Peeters
Louis L H
LL
D000328:Adult; D005260:Female; D017359:HELLP Syndrome / Q000175:diagnosis*; D006801:Humans; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D012008:Recurrence