A risk prediction model for the assessment and triage of women with hypertensive disorders of pregnancy in low-resourced settings : the miniPIERS (pre-eclampsia integrated estimate of risk) multi-country prospective cohort study

Simple item page
dc.contributor.authorPayne, Beth A.en_ZA
dc.contributor.authorHutcheon, Jennifer A.en_ZA
dc.contributor.authorAnsermino, J. Marken_ZA
dc.contributor.authorHall, David R.en_ZA
dc.contributor.authorBhutta, Zulfiqar A.en_ZA
dc.contributor.authorBhutta, Shereen Z.en_ZA
dc.contributor.authorBiryabarema, Christineen_ZA
dc.contributor.authorGrobman, William A.en_ZA
dc.contributor.authorGroen, Henken_ZA
dc.contributor.authorHaniff, Farizahen_ZA
dc.contributor.authorLi, Jingen_ZA
dc.contributor.authorMagee, Laura A.en_ZA
dc.contributor.authorMerialdi, Marioen_ZA
dc.contributor.authorNakimuli, Annetteeen_ZA
dc.contributor.authorQu, Ziguangen_ZA
dc.contributor.authorSikandar, Rozinaen_ZA
dc.contributor.authorSass, Nelsonen_ZA
dc.contributor.authorSawchuck, Dianeen_ZA
dc.contributor.authorSteyn, D. Wilhelmen_ZA
dc.contributor.authorWidmer, Marianaen_ZA
dc.contributor.authorZhou, Jianen_ZA
dc.contributor.authorVon Dadelszen, Peteren_ZA
dc.date.accessioned2016-03-16T09:04:38Z
dc.date.available2016-03-16T09:04:38Z
dc.date.issued2014-01-21
dc.descriptionPlease cite as follows: Payne, B. A. 2014. A risk prediction model for the assessment and triage of women with hypertensive disorders of pregnancy in low-resourced settings: the miniPIERS (pre-eclampsia integrated estimate of risk) multi-country prospective cohort study. PLoS Medicine, 11(1):e1001589, doi:10.1371/journal.pmed.1001589.en_ZA
dc.descriptionThe original publication is available at http://journals.plos.org/plosmedicineen_ZA
dc.description.abstractBackground: Pre-eclampsia/eclampsia are leading causes of maternal mortality and morbidity, particularly in low- and middle- income countries (LMICs). We developed the miniPIERS risk prediction model to provide a simple, evidence-based tool to identify pregnant women in LMICs at increased risk of death or major hypertensive-related complications. Methods and Findings: From 1 July 2008 to 31 March 2012, in five LMICs, data were collected prospectively on 2,081 women with any hypertensive disorder of pregnancy admitted to a participating centre. Candidate predictors collected within 24 hours of admission were entered into a step-wise backward elimination logistic regression model to predict a composite adverse maternal outcome within 48 hours of admission. Model internal validation was accomplished by bootstrapping and external validation was completed using data from 1,300 women in the Pre-eclampsia Integrated Estimate of RiSk (fullPIERS) dataset. Predictive performance was assessed for calibration, discrimination, and stratification capacity. The final miniPIERS model included: parity (nulliparous versus multiparous); gestational age on admission; headache/visual disturbances; chest pain/dyspnoea; vaginal bleeding with abdominal pain; systolic blood pressure; and dipstick proteinuria. The miniPIERS model was well-calibrated and had an area under the receiver operating characteristic curve (AUC ROC) of 0.768 (95% CI 0.735–0.801) with an average optimism of 0.037. External validation AUC ROC was 0.713 (95% CI 0.658–0.768). A predicted probability ≥25% to define a positive test classified women with 85.5% accuracy. Limitations of this study include the composite outcome and the broad inclusion criteria of any hypertensive disorder of pregnancy. This broad approach was used to optimize model generalizability. Conclusions: The miniPIERS model shows reasonable ability to identify women at increased risk of adverse maternal outcomes associated with the hypertensive disorders of pregnancy. It could be used in LMICs to identify women who would benefit most from interventions such as magnesium sulphate, antihypertensives, or transportation to a higher level of care.en_ZA
dc.description.urihttp://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001589
dc.description.versionPublisher's versionen_ZA
dc.format.extent13 pagesen_ZA
dc.identifier.citationPayne, B. A. 2014. A risk prediction model for the assessment and triage of women with hypertensive disorders of pregnancy in low-resourced settings: the miniPIERS (pre-eclampsia integrated estimate of risk) multi-country prospective cohort study. PLoS Medicine, 11(1):e1001589, doi:10.1371/journal.pmed.1001589.en_ZA
dc.identifier.issn1549-1676 (online)
dc.identifier.otherdoi:10.1371/journal.pmed.1001589
dc.identifier.urihttp://hdl.handle.net/10019.1/98881
dc.language.isoen_ZAen_ZA
dc.publisherPLoSen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectHypertension in pregnancyen_ZA
dc.subjectPregnancy -- Complicationsen_ZA
dc.subjectPreeclampsiaen_ZA
dc.subjectPregnance women -- Health and hygieneen_ZA
dc.titleA risk prediction model for the assessment and triage of women with hypertensive disorders of pregnancy in low-resourced settings : the miniPIERS (pre-eclampsia integrated estimate of risk) multi-country prospective cohort studyen_ZA
dc.typeArticleen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
payne_risk_2014.pdf
Size:
344.24 KB
Format:
Adobe Portable Document Format
Description:
Download article
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
1.95 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Research Articles (Obstetrics and Gynaecology)