Risk indicators for eclampsia in gestational hypertension or mild preeclampsia at term.
OBJECTIVE
To evaluate whether eclampsia can be predicted in gestational hypertension or mild preeclampsia at term.


METHODS
For this case-control study we selected 76 cases with eclampsia from the LEMMoN study and 1149 controls with mild hypertensive disease of pregnancy, who did not develop eclampsia, from the HYPITAT study. Risk indicators for eclampsia, identified in multivariable logistic regression, were used to assess the predictive capacity of our model with receiver-operating characteristic (ROC) curve analysis. Model optimism was assessed with bootstrapping.


RESULTS
Maternal age, non-Caucasian ethnicity, systolic blood pressure >155 mmHg, ≥2+ protein on dipstick, elevated uric acid, creatinin >74 μmol/L, aspartate aminotransferase >30 U/L, and lactate dehydrogenase >400 U/L were significantly associated with eclampsia. Other factors included in the model were previous fetal loss, previous miscarriage, gestational age, and low platelet count. The area under the ROC curve was 0.92. Bootstrapping showed minimal overfitting of the model.


CONCLUSIONS
In women with gestational hypertension or mild preeclampsia at term eclampsia can be predicted.
Koopmans
Corine M
CM
Department of Obstetrics and Gynecology, University Medical Centre Groningen, Groningen, The Netherlands. C.M.Koopmans@og.umcg.nl
Zwart
Joost J
JJ
Groen
Henk
H
Bloemenkamp
Kitty W M
KW
Mol
Ben W J
BW
Van Pampus
Maria G
MG
Van Roosmalen
Jos
J
D000328:Adult; D016022:Case-Control Studies; D004461:Eclampsia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D009426:Netherlands / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011296:Prenatal Diagnosis; D012372:ROC Curve; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult