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Simple Prepregnant Prediction Rule for Recurrent Early-onset Hypertensive Disease in Pregnancy

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Abstract

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.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, University Medical Centre Maastricht and the Research Institute Growth and Development (GROW), Maastricht University, Faculty of Medicine, Maastricht, Netherlands

    Simone J. S. Sep MSc & Louis L. H. Peeters MD, PhD

  2. Department of Epidemiology, School for Public Health and Primary Care (Caphri), Maastricht University, PO Box 616, 6200 MD, Maastricht, Netherlands

    Simone J. S. Sep MSc, Luc J. M. Smits PhD & Martin H. Prins MD, PhD

  3. Department of Obstetrics and Gynaecology, University Medical Centre, Nijmegen, Netherlands

    Marc E. A. Spaanderman MD, PhD

Authors
  1. Simone J. S. Sep MSc
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  2. Luc J. M. Smits PhD
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  3. Martin H. Prins MD, PhD
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  4. Marc E. A. Spaanderman MD, PhD
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  5. Louis L. H. Peeters MD, PhD
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Correspondence to Simone J. S. Sep MSc.

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Sep, S.J.S., Smits, L.J.M., Prins, M.H. et al. Simple Prepregnant Prediction Rule for Recurrent Early-onset Hypertensive Disease in Pregnancy. Reprod. Sci. 16, 80–87 (2009). https://doi.org/10.1177/1933719108324889

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  • DOI: https://doi.org/10.1177/1933719108324889

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