TY - JOUR
T1 - Comparison of three algorithms for prediction preeclampsia in the first trimester of pregnancy
AU - Rocha, Rebeca Silveira
AU - Gurgel Alves, Júlio Augusto
AU - Bezerra Maia E Holanda Moura, Sammya
AU - Araujo Júnior, Edward
AU - Martins, Wellington P.
AU - Vasconcelos, Camila Teixeira Moreira
AU - Da Silva Costa, Fabricio
AU - Oriá, Mônica Oliveira Batista
PY - 2017/10
Y1 - 2017/10
N2 - Objective: To compare a new simple algorithm for preeclampsia (PE) prediction among Brazilian women with two international guidelines - National Institute for Clinical Excellence (NICE) and American College of Obstetricians and Gynecologists (ACOG). Methods: We performed a secondary analysis of two prospective cohort studies to predict PE between 11 and 13 + 6. weeks of gestation, developed between August 2009 and January 2014. Outcomes measured were total PE, early PE (<34. weeks), preterm PE (<37. weeks), and term PE (≥37. weeks). The predictive accuracy of the models was assessed using the area under the receiver operator characteristic curve (AUC-ROC) and via calculation of sensitivity and specificity for each outcome. Results: Of a total of 733 patients, 55 patients developed PE, 12 at early, 21 at preterm and 34 at term. The AUC-ROC values were low, which compromised the accuracy of NICE (AUC-ROC: 0.657) and ACOG (AUC-ROC: 0.562) algorithms for preterm PE prediction in the Brazilian population. The best predictive model for preterm PE included maternal factors (MF) and mean arterial pressure (MAP) (AUC-ROC: 0.842), with a statistically significant difference compared with ACOG (p. <. 0.0001) and NICE (p = 0.0002) guidelines. Conclusion: The predictive accuracies of NICE and ACOG guidelines to predict preterm PE were low and a simple algorithm involving maternal factors and MAP performed better for the Brazilian population.
AB - Objective: To compare a new simple algorithm for preeclampsia (PE) prediction among Brazilian women with two international guidelines - National Institute for Clinical Excellence (NICE) and American College of Obstetricians and Gynecologists (ACOG). Methods: We performed a secondary analysis of two prospective cohort studies to predict PE between 11 and 13 + 6. weeks of gestation, developed between August 2009 and January 2014. Outcomes measured were total PE, early PE (<34. weeks), preterm PE (<37. weeks), and term PE (≥37. weeks). The predictive accuracy of the models was assessed using the area under the receiver operator characteristic curve (AUC-ROC) and via calculation of sensitivity and specificity for each outcome. Results: Of a total of 733 patients, 55 patients developed PE, 12 at early, 21 at preterm and 34 at term. The AUC-ROC values were low, which compromised the accuracy of NICE (AUC-ROC: 0.657) and ACOG (AUC-ROC: 0.562) algorithms for preterm PE prediction in the Brazilian population. The best predictive model for preterm PE included maternal factors (MF) and mean arterial pressure (MAP) (AUC-ROC: 0.842), with a statistically significant difference compared with ACOG (p. <. 0.0001) and NICE (p = 0.0002) guidelines. Conclusion: The predictive accuracies of NICE and ACOG guidelines to predict preterm PE were low and a simple algorithm involving maternal factors and MAP performed better for the Brazilian population.
KW - First trimester pregnancy
KW - Maternal characteristics
KW - Mean arterial pressure
KW - Prediction
KW - Preeclampsia
UR - https://www.scopus.com/pages/publications/85026405300
U2 - 10.1016/j.preghy.2017.07.146
DO - 10.1016/j.preghy.2017.07.146
M3 - Article
AN - SCOPUS:85026405300
SN - 2210-7789
VL - 10
SP - 113
EP - 117
JO - Pregnancy Hypertension
JF - Pregnancy Hypertension
ER -