Discriminatory Accuracy of Preeclampsia Risk Factors in Primary Care.
Arch Med Res
; 49(4): 240-247, 2018 05.
Article
en En
| MEDLINE
| ID: mdl-30266532
ABSTRACT
BACKGROUND:
Although it is common to use risk factors in the screening for preeclampsia, they do not always accurately identify patients who truly have this condition. AIM OF THE STUDY To determine the discriminatory accuracy of known preeclampsia risk factors, both individually and in combination.METHODS:
We studied patients undergoing prenatal care who were diagnosed with preeclampsia or eclampsia (n = 160 cases) in primary care and those who were not (n = 430 controls). Data on history of preeclampsia, type 2 diabetes, chronic hypertension, multiple gestation, first pregnancy, pregnancy interval ≥10 years, overweight/obesity, mean arterial pressure (MAP) ≥80 mmHg, and age (<20 years and ≥40 years) were obtained using a dichotomous scale. Discriminatory accuracy indicators were true-positive (TP) and false-positive (FP) rates, positive and negative likelihood ratios (LR+ and LR-), diagnostic odds ratio (DOR), and the area under the receiver-operating characteristic (AUROC) curve; stratified by parity. The case-control status was the reference standard.RESULTS:
Certain combinations performed better than individual factors, independent of parity status. Among multiparous women, MAP ≥80 mmHg together with previous preeclampsia and overweight/obesity accumulated the greatest number of discriminatory accuracy indicators, with acceptable values TP, 72.2%; FP, 1.5%; LR+, 48.4; LR-, 0.3; DOR, 171.6; and AUROC, 0.85.CONCLUSIONS:
Discriminatory accuracy was low for almost all individual preeclampsia risk factors. However, the accuracy improved after some factors were combined. To the best of our knowledge, this is the first study to examine the discriminatory accuracy of preeclampsia risk factors used for screening high-risk pregnancies in primary care in Mexico.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Preeclampsia
/
Factores de Riesgo
/
Eclampsia
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Equity_inequality
Límite:
Adult
/
Female
/
Humans
/
Pregnancy
País/Región como asunto:
Mexico
Idioma:
En
Revista:
Arch Med Res
Asunto de la revista:
MEDICINA
Año:
2018
Tipo del documento:
Article