Prediction of complications of pre-eclampsia using the fullPIERS high risk predictive model

Int J Gynaecol Obstet. 2023 Dec;163(3):983-988. doi: 10.1002/ijgo.14920. Epub 2023 Jun 16.

Abstract

Objective: To determine the predicted probability percentage of complications in women with pre-eclampsia using the Pre-eclampsia Integrated Estimate of Risk (fullPIERS) model within the first 24 h after admission and assess the model's predictive value for complications of pre-eclampsia.

Methods: This was a prospective cohort study in which the fullPIERS model was applied to 256 pregnant women with pre-eclampsia within the first 24 h after admission. These women were then followed for 48 h to 7 days for maternal and fetal complications. Reciever operating characteristics (ROC) curves were generated to assess the performance of the fullPIERS model for adverse outcomes of pre-eclampsia.

Results: Of the 256 women enrolled in the study, 101 women (39.5%) developed maternal complications, 120 women (46.9%) developed fetal complications, and 159 women (62.1%) developed both. With an area under the ROC curve of 0.843 (95% confidence interval 0.789-0.897), the fullPIERS model had good discriminating ability to predict complications at any time point between 48 h and 7 days after admission. The sensitivity and specificity of the model at a ≥5.9% cut-off value for predicting adverse maternal outcomes were 60% and 97%, respectively; they were 44% and 96%, respectively, for predicting combined fetomaternal complications with a cut-off value of 4.9%.

Conclusions: The fullPIERS model performs reasonably well in predicting adverse maternal and fetal outcomes in women with pre-eclampsia.

Keywords: fullPIERS model; hypertensive disorders of pregnancy; pre-eclampsia; predictive models; screening.

MeSH terms

  • Female
  • Humans
  • Pre-Eclampsia* / diagnosis
  • Pre-Eclampsia* / epidemiology
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Outcome
  • Prospective Studies
  • Risk Assessment
  • Risk Factors