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Using clinical symptoms to predict adverse maternal and perinatal outcomes in women with preeclampsia: data from the PIERS (Pre-eclampsia Integrated Estimate of RiSk) study.

Yen, TW; Payne, B; Qu, Z; Hutcheon, JA; Lee, T; Magee, LA; Walters, BN; von Dadelszen, P (2011) Using clinical symptoms to predict adverse maternal and perinatal outcomes in women with preeclampsia: data from the PIERS (Pre-eclampsia Integrated Estimate of RiSk) study. Journal of Obstetrics and Gynaecology Canada, 33 (8). pp. 803-809. ISSN 1701-2163
SGUL Authors: von Dadelszen, Peter

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OBJECTIVES: Preeclampsia is a leading cause of maternal morbidity. The clinical challenge lies in predicting which women with preeclampsia will suffer adverse outcomes and would benefit from treatment, while minimizing potentially harmful interventions. Our aim was to determine the ability of maternal symptoms (i.e., severe nausea or vomiting, headache, visual disturbance, right upper quadrant pain or epigastric pain, abdominal pain or vaginal bleeding, and chest pain or dyspnea) to predict adverse maternal or perinatal outcomes. METHODS: We used data from the PIERS (Pre-eclampsia Integrated Estimate of RiSk) study, a multicentre, prospective cohort study designed to investigate the maternal risks associated with preeclampsia. Relative risks and receiver operating characteristic (ROC) curves were assessed for each preeclampsia symptom and outcome pair. RESULTS: Of 2023 women who underwent assessment, 52% experienced at least one preeclampsia symptom, with 5.2% and 5.3% respectively experiencing an adverse maternal or perinatal outcome. No symptom and outcome pair, in either of the maternal or perinatal groups, achieved an area under the ROC curve value > 0.7, which would be necessary to demonstrate a discriminatory predictive value. CONCLUSION: Maternal symptoms of preeclampsia are not independently valid predictors of maternal adverse outcome. Caution should be used when making clinical decisions on the basis of symptoms alone in the preeclamptic patient.

Item Type: Article
Additional Information: © 2011 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved. Made available with permission from the publisher. Contact publisher for any further re-use.
Keywords: Adult, Cohort Studies, Female, Humans, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Prognosis, Prospective Studies, ROC Curve, Risk Factors, Humans, Pregnancy Complications, Pre-Eclampsia, Prognosis, Pregnancy Outcome, Risk Factors, Cohort Studies, Prospective Studies, ROC Curve, Pregnancy, Adult, Female, 1114 Paediatrics And Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Journal of Obstetrics and Gynaecology Canada
ISSN: 1701-2163
Language: eng
1 August 2011Published
Publisher License: Publisher's own licence
Project IDFunderFunder ID
UNSPECIFIEDCanadian Institutes of Health ResearchUNSPECIFIED
PubMed ID: 21846435
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