Hypertension in Pregnancy (Oct 2021)
Predictability of adverse outcomes in hypertensive disorders of pregnancy: a multicenter prospective cohort study
- Daniela N. Vasquez,
- Andrea V. Das Neves,
- Vanina M. Aphalo,
- Laura Vidal,
- Miriam Moseinco,
- Jorge Lapadula,
- Analía Santa-Maria,
- Graciela Zakalik,
- Raúl A. Gomez,
- Mónica Capalbo,
- Claudia Fernandez,
- Enrique Agüero-Villareal,
- Santiago Vommaro,
- Marcelo Moretti,
- Silvana B. Soli,
- Florencia Ballestero,
- Juan P. Sottile,
- Viviana Chapier,
- Carlos Lovesio,
- José Santos,
- Fernando Bertoletti,
- Fernando A. Mos,
- Alejandro Risso-Vazquez,
- Mercedes Esteban-Chacon,
- Santiago Illutovich,
- Sebastián Chapela,
- Cecilia I. Loudet,
- José L. Scapellato,
- Alfredo D. Intile,
- Elisa Estenssoro
Affiliations
- Daniela N. Vasquez
- Sanatorio Anchorena
- Andrea V. Das Neves
- Hospital Interzonal De Agudos Gral. San Martín
- Vanina M. Aphalo
- Sanatorio Anchorena
- Laura Vidal
- Hospital Pablo Soria
- Miriam Moseinco
- Sanatorio Otamendi
- Jorge Lapadula
- Hospital Nacional Prof. Alejandro Posadas
- Analía Santa-Maria
- Sanatorio Mitre
- Graciela Zakalik
- Hospital Luis Lagomaggiore
- Raúl A. Gomez
- Sanatorio De Los Arcos
- Mónica Capalbo
- Hospital Gral De Agudos José M.Penna
- Claudia Fernandez
- Hospital De Agudos Ramón Madariaga
- Enrique Agüero-Villareal
- Hospital Policlínico Regional Dr. Ramón Carrillo
- Santiago Vommaro
- Sanatorio Mater Dei
- Marcelo Moretti
- Hospital Naval
- Silvana B. Soli
- Sanatorio Julio Corzo
- Florencia Ballestero
- Hospital Británico
- Juan P. Sottile
- Hospital Zonal Bariloche
- Viviana Chapier
- Hospital Español De Mendoza
- Carlos Lovesio
- Sanatorio Parque
- José Santos
- Clínica Colón
- Fernando Bertoletti
- Sanatorio San Jorge
- Fernando A. Mos
- Sanatorio Anchorena
- Alejandro Risso-Vazquez
- Sanatorio Otamendi
- Mercedes Esteban-Chacon
- Hospital Nacional Prof. Alejandro Posadas
- Santiago Illutovich
- Hospital Luis Lagomaggiore
- Sebastián Chapela
- Hospital Británico
- Cecilia I. Loudet
- Hospital Interzonal De Agudos Gral. San Martín
- José L. Scapellato
- Sanatorio Anchorena
- Alfredo D. Intile
- Sanatorio Anchorena
- Elisa Estenssoro
- Hospital Interzonal De Agudos Gral. San Martín
- DOI
- https://doi.org/10.1080/10641955.2021.1981373
- Journal volume & issue
-
Vol. 40,
no. 4
pp. 279 – 287
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