Prediction of adverse maternal outcome in women with preeclampsia using fullPIERS model: observations from a tertiary care hospital

Abstract

Background: Globally about 10% of pregnancies are complicated by preeclampsia (PE) and other hypertensive disorders of pregnancy. PE is associated with higher near miss maternal morbidity and mortality. PIERS (Preeclampsia Integrated Estimate of Risk Scoring) model was designed for monitoring of women with preeclampsia and to do the risk stratification for improving the management. Objectives: This study was undertaken to analyze the adverse maternal outcome using fullPIERS risk prediction model in women with preeclampsia. Methods: It was a prospective cohort study over a period of one year. Women with PE, who gave consent were enrolled. All were subjected to fullPIERS calculator for predicting the risk of adverse maternal outcome after obtaining the predictor variables. Results: The number of obstetric admissions in our hospital during the period were 13,351. Of them 1389 (10.3%) women had PE. Amongst 150 enrolled women with PE, fullPIERS score of 35 gave the maximum performance in predicting adverse maternal outcomes. 36.6% women in our cohort experienced an adverse maternal outcome, including one maternal death. The relative risk for predicting adverse maternal outcomes in women with fullPIERS score of ≥ 35 was 4.6[95% CI (2.5-8.4)] and AUC for ROC was 0.854;[95% CI (0.78-0.91)]. Conclusion: In women with PE, fullPIERS score ≥ 35is significantly associated with adverse maternal outcome.

Keywords

• preclampsia
• maternal
• outcome
• fullpiers