PREDICTING MATERNAL AND PERINATAL COMPLICATIONS IN EARLYSEVERE PREECLAMPSIA: DEVELOPMENT A PROGNOSTIC MODEL

Abstract

Introduction: Severe preeclampsia is one of the causes of maternal and perinatal morbidity and mortality worldwide.
After the diagnosis of severe preeclampsia, we need to plan further management. And we need an accurate assessment of
the risk of complications, both for the mother and the fetus. Predictive models using patient clinical and laboratory data are
an alternative basis for clinical practice. It is necessary for the use of personalized medicine and for predicting future
outcomes in specific patients and for making clinical decisions.
Aim: The aim of this study was to develop a prognostic model for predicting maternal and perinatal complications in early
severe preeclampsia.
Materials and methods: This prospective cohort study was conducted in the perinatal centers of Semey and Pavlodar
from July 1, 2018 to July 1, 2019. Participants consisted of 250 24-34 weeks pregnant women with severe preeclampsia.
The correlation between each predictor candidate and target outcomes was analyzed using one-way analysis. For further
analysis, the criterion of the significance of predictor candidates with p <0.1 was used. Further, the study of the possibility of
predicting complications of pregnancy accompanied by severe PE and eclampsia, depending on prenatal factors and term of
delivery, was performed using the methods of ROC- analysis and binary logistic regression. The critical level of significance
p when testing statistical hypotheses in this study was taken equal to 0,05.
Results: 5 variables we were used to build our models (fibrinogen, urea, uric acid, LDH, blood flow disorders according
to dopplerometry). Our prognosis model was showed a good predictive ability to predict preterm placental abruption AUC =
0.77 ± 0.1 (95% CI: 0.58-0.96), and perinatal mortality (including antenatal fetal death AUC = 0, 77 ± 0.1 (95% CI: 0.58-
0.96)) in conditions of expectant management of severe preeclampsia, especially at 27-29 weeks of pregnancy.
Conclusions: In our study, models were created for predicting maternal perinatal complications in pregnant women with
severe preeclampsia at 24-34 weeks of pregnancy. They were showed good predictive ability. They are also available and
can be easy to use in clinical practice as a statistical calculator.