Author(s)
Tan J1, Yang M2, Liao Y3, Qi YN1, Ren Y1, Liu CR1, Huang S1, Thabane L4, Liu XH3, Sun X1
1Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China, 2West China School of Public Health, Sichuan University, Chengdu, China, 3Department of Obstetrics and Gynecology, and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education; West China Second University Hospital, Sichuan University, Chengdu, China, 4Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton ON, Canada; Biostatistics Unit, St Joseph’s Healthcare—Hamilton, Hamilton, ON, Canada
OBJECTIVES : Pre-eclampsia is a severe hypertensive disorder of pregnancy and could lead to severe maternal morbidities and death. We aimed to develop and validate a prognostic prediction model for severe maternal outcomes among Chinese population with pre-eclampsia. METHODS : We conducted a 10-year cohort study in West China Second Hospital of Sichuan University by collecting data of all pregnant women who diagnosed as pre-eclampsia and delivered at this hospital from 2005 to 2014. We adopted a composite of severe maternal outcomes, including maternal near-miss defined by World Health Organization, cortical blindness/retinal detachment, temporary facial paralysis and maternal death. The span of time for prediction was from the diagnosis of pre-eclampsia to delivery or discharge within seven days after diagnosis. We firstly included candidate predictors with univariable analysis of p < 0.1 and without substantial collinearity, and then conducted multivariate imputation by chained equations (MICE) for predictors with a missing ratio more than 5%. We used logistic regression model to develop Model 1 by retaining the predictors of p < 0.05, and further conducted Model 2 by adding quadratic terms and interaction terms to Model 1. We undertook an internal validation by bootstrapping technology and estimated the model performance. RESULTS : A total of 397 pregnant women with pre-eclampsia suffered from severe maternal outcomes among 2793 eligible participants, with an incidence of 14.21% (95%CI, 12.91%–15.51%). Of 13 predictors were selected by multivariable logistic regression, and all were readily available in the Chinese setting. Combined with quadratic and interactive terms, the Model 2 showed higher area under the ROC curve (82.2%, 79.6%–84.7%) and good calibration. By the bootstrapping validation, similar model performances were present. CONCLUSIONS : A prediction model for severe maternal outcomes in pregnant women with pre-eclampsia was established in Chinese setting. The model presents a good predictive ability by internal validation.
Conference/Value in Health Info
2020-09, ISPOR Asia Pacific 2020, Seoul, South Korea
Value in Health Regional, Volume 22S (September 2020)
Code
PIH1
Topic
Clinical Outcomes, Methodological & Statistical Research
Topic Subcategory
Clinical Outcomes Assessment
Disease
Reproductive and Sexual Health
