Model predicts adverse outcomes in women with preeclampsia

A new model may predict which women are in danger of death or serious complications associated with preeclampsia as early as 7 days before problems appear, a prospective, multicenter study reports.

The model, called fullPIERS (Preeclampsia Integrated Estimate of RiSk), was originated by researchers at the University of British Columbia, Vancouver, Canada, and internally validated in women who were admitted to tertiary obstetric centers with preeclampsia or who developed the condition after admission. The study, published online December 24 in The Lancet, aimed to recognize risk of fatal or life-threatening complications within 48 hours of hospital admission.

“The fullPIERS model identifies woman at increased risk of adverse outcomes up to 7 days before complications arise and can thereby modify direct patient care (eg, timing of delivery, place of care), improve the design of clinical trials, and inform biomedical investigations related to preeclampsia,” the authors write.

The study found that 261 of 2023 women with preeclampsia suffered adverse events at any time after admission to the hospital; 106 (5%) developed complications within 48 hours of admission. Predictors of adverse maternal outcomes included gestational age, chest pain or dyspnea, oxygen saturation, platelet count, and creatinine and aspartate transaminase concentrations.

The fullPIERS model predicted adverse outcomes within 48 hours of when women became eligible for the study and worked well for as long as 7 days after they became eligible.