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Multicenter Study
. 2021 Nov;40(4):279-287.
doi: 10.1080/10641955.2021.1981373. Epub 2021 Sep 29.

Predictability of adverse outcomes in hypertensive disorders of pregnancy: a multicenter prospective cohort study

Daniela N Vasquez  1   2 , Andrea V Das Neves  2 , Vanina M Aphalo  1 , Laura Vidal  3 , Miriam Moseinco  4 , Jorge Lapadula  5 , Analía Santa-Maria  6 , Graciela Zakalik  7 , Raúl A Gomez  8 , Mónica Capalbo  9 , Claudia Fernandez  10 , Enrique Agüero-Villareal  11 , Santiago Vommaro  12 , Marcelo Moretti  13 , Silvana B Soli  14 , Florencia Ballestero  15 , Juan P Sottile  16 , Viviana Chapier  17 , Carlos Lovesio  18 , José Santos  19 , Fernando Bertoletti  20 , Fernando A Mos  1 , Alejandro Risso-Vazquez  4 , Mercedes Esteban-Chacon  5 , Santiago Illutovich  7 , Sebastián Chapela  15 , Cecilia I Loudet  2 , José L Scapellato  1 , Alfredo D Intile  1 , Elisa Estenssoro  2
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Free article
Multicenter Study

Predictability of adverse outcomes in hypertensive disorders of pregnancy: a multicenter prospective cohort study

Daniela N Vasquez et al. Hypertens Pregnancy. 2021 Nov.
Free article

Abstract

Objectives: To explore variables associated with adverse maternal/fetal/neonatal outcomes among pregnant/postpartum patients admitted to ICU for hypertensive disorders of pregnancy (HDP).

Methods: Multicenter, prospective, national cohort study.

Results: Variables independently associated with maternal/fetal/neonatal mortality among 172 patients were as follows: Acute Physiology and Chronic Health Evaluation-II (APACHE-II)(OR1.20[1.06-1.35]), gestational age (OR0.698[0.59-0.82]) and aspartate aminotransferase (AST)(OR1.004[1.001-1.006]). Positive likelihood ratio for headache, epigastric pain, and visual disturbances to predict composite adverse outcomes were 1.23(1.16-1.30), 0.76(0.59-1.02), and 1.1(0.98-1.2), respectively.

Conclusions: Maternal/fetal mortality due to HDP was independently associated with severity of illness on admission, gestational age, and elevated AST. Accuracy of clinical symptoms to predict composite adverse outcomes was low.

Keywords: Hypertension; fetal mortality; maternal mortality; predictive value; pregnancy; risk factors.

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