blogger delicious digg diigo facebook googleplus linkedin netlog reddit twitter
Skip Navigation LinksJRI > Archive > January-March 2010, Volume 10, Issue 4 > A Predictive Model for the Diagnosis of Preeclampsia



Volume 10, Issue 4, Number 41 / January-March
(pages 261-267)


A Predictive Model for the Diagnosis of Preeclampsia




Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

 Corresponding Author
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Department of Midwifery, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

Received: 5/24/2009 Accepted: 9/9/2009

Related Articles
in Google Scholar in PubMed

 

Other Format
pdfPDF Full Text (En) pdfPDF Full Text (Fa) pdfePUB Full Text (En) pdfPDF Abstract (En) pdfPDF Abstract (Fa) pdf BibTeX pdfRefMan pdfEndNote xmlPMC XML online readerPMC Reader

 


Abstract
Introduction: Preeclampsia is one of the three main causes of death in pregnant women. The medical condition is identified by hypertension and proteinuria with serious effects on the health of mother and the fetus. There seems to be no precise methods to diagnose preeclampsia at its onset. This study was done to evaluate the simultaneous measurement of some variables thought to be responsible in the pathogenesis of preeclampsia for predicting or screening those at risk. Materials and Methods: In this study, 466 primiparas were selected randomly among the bulk of pregnant women who attended Maryam Hospital for prenatal care in Tehran, Iran during 2007-2008. The subjects had no history of chronic health conditions and regularly took Iron supplements. The predictive variables included age, job, education, income, number of pervious marriages, BMI during the first trimester of pregnancy, age at the time of recruitment for the study, changes in hematocrit concentration at the beginning and the 24th to 28th weeks of pregnancy, blood pressure and roll-over test during 28th to 32nd week of gestation but the onset of preeclampsia was considered as a dependent variable. For analyzing the overall effects of the mentioned variables on prediction of the disease, multivariate logistic regression analysis was employed and ROC curves were used for determining a suitable cut-off point for determining the sensitivity and specificity of the model. Results: The prevalence of preeclampsia was 6.4% (95% CI: 4.2-8.6). Variables such as positive roll-over test, fulfillment of university education, marriage more than once, high blood pressure during the 24th-28th weeks of gestation, being a housekeeper, satisfaction with income, positive roll over test at a late stage of gestation and increase in BMI raised the risk of preeclampsia 8.61, 7.98, 2.65, 1.84, 1.56, 1.28, 1.21 and 1.11 times respectively. The proposed logistic regression model had a sensitivity of 83% and a specificity of 76% regarding the inclusion of all the mentioned variables.Conclusion: Regarding the serious complications and negative effects of preeclampsia on both the mother and the fetus and the high sensitivity of this logistic regression model and imposition of no costs on the person for the measurement of the variables, this model seems to be suitable for the screening of preeclampsia.

Keywords: Blood pressure, Body Mass Index, Diagnosis, Logistic models, Predictive, Preeclampsia, Pregnancy complications, Risk factor


To cite this article:



Figures, Charts, Tables

References
  1. Heilmann L, Siekmann U. Hemodynamic and hemorheological profiles in women with proteinuric hypertension of pregnancy and in pregnant controls. Arch Gynecol Obstet. 1989;246(3):159-68. Review.   [PubMed]
  2. Douglas KA, Redman CW. Eclampsia in the United Kingdom. BMJ. 1994;309(6966):1395-400.   [PubMed]
  3. Heilmann L, Rath W, Pollow K. Hemorheological changes in women with severe preeclampsia. Clin Hemorheol Microcirc. 2004;31(1):49-58.   [PubMed]
  4. Hentush Zade S. [Investigation thyroid dysfunc-tional disorder between preeclampsia women and other women]. 8th international obstetrics & gyne-cology congress; 2003 Oct 4-8; Tehran. Tehran Uni-versity of Medical Science;2005. p.104. Persian.
  5. Dekker GA, Sibai BM. Early detection of pre-eclampsia. Am J Obstet Gynecol. 1991;165(1):160-72. Review.   [PubMed]
  6. Fayyad AM, Harrington KF. Prediction and preven-tion of preeclampsia and IUGR. Early Hum Dev. 2005;81(11):865-76. Review.   [PubMed]
  7. Friedman SA, Neff RK. Pregnancy Hypertension: Clinical diagnosis criteria. Am J obstet Gynecol. 2005;(217):141-62.
  8. Hatfield A, Robinson E. The 'debriefing' of clients following the birth of a baby. Pract Midwife. 2002; 5(5):14-6.   [PubMed]
  9. Rudra CL, Williams MA. BMI as a modifying factor in the relations between age at menarche, menstrual cycle characteristics, and risk of preeclampsia. Gynecol Endocrinol. 2005;21(4):200-5.   [PubMed]
  10. Mittendorf R, Lain KY, Williams MA, Walker CK. Preeclampsia. A nested, case-control study of risk factors and their interactions. J Reprod Med. 1996; 41(7):491-6.   [PubMed]
  11. Klonoff-Cohen HS, Cross JL, Pieper CF. Job stress and preeclampsia. Epidemiology. 1996;7(3):245-9.   [PubMed]
  12. Zhang J, Patel G. Partner change and perinatal outcomes: a systematic review. Paediatr Perinat Epidemiol. 2007;21 Suppl 1:46-57.   [PubMed]
  13. Lachmeijer AM, Crusius JB, Pals G, Dekker GA, Arngrímsson R, ten Kate LP. Polymorphisms in the tumor necrosis factor and lymphotoxin-alpha gene region and preeclampsia. Obstet Gynecol. 2001;98(4):612-9.   [PubMed]
  14. Kazemi A. [Sperm exposure and development of preeclampsia]. J Qazvin Univ Med Sci. 2008; 12(2):83-8. Persian.   [Abstract]
  15. Cunningham F, Williams W. Williams Obstetrics. 22nd ed. New York: McGraw-Hill Professional Publishing; 2005. 805 p.
  16. Duley L. Pre-eclampsia and the hypertensive dis-orders of pregnancy. Br Med Bull. 2003;67:161-76. Review.   [PubMed]
  17. Sibai BM, Hauth J, Caritis S, Lindheimer MD, MacPherson C, Klebanoff M, et al. Hypertensive disorders in twin versus singleton gestations. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. Am J Obstet Gynecol. 2000;182(4):938-42.   [PubMed]
  18. Su YN, Lee CN, Cheng WF, Shau WY, Chow SN, Hsieh FJ. Decreased maternal serum placenta growth factor in early second trimester and pre-eclampsia. Obstet Gynecol. 2001;97(6):898-904.   [PubMed]
  19. Sibai BM, Koch MA, Freire S, Pinto e Silva JL, Rudge MV, Martins-Costa S, et al. Serum inhibin A and angiogenic factor levels in pregnancies with previous preeclampsia and/or chronic hypertension: are they useful markers for prediction of subsequent preeclampsia? Am J Obstet Gynecol. 2008;199(3):268.e1-9.   [PubMed]



Home | About Us | Current Issue | Past Issues | Submit a Manuscript | Instructions for Authors | Subscribe | Search | Contact Us

"Journal of Reproduction & Infertility" is owned, published, and copyrighted by Avicenna Research Institute .
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

Journal of Reproductoin and Infertility (JRI) is a member of COMMITTEE ON PUBLICATION ETHICS . Verify here .

©2016 - eISSN : 2251-676X, ISSN : 2228-5482, For any comments and questions please contact us.