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

DOI
https://doi.org/10.1080/10641955.2021.1981373
Journal volume & issue
Vol. 40, no. 4
pp. 279 – 287

Abstract

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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.

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