Screening de primer trimestre de preeclampsia tardía en gestantes de bajo riesgo en un centro de bajo volumen obstétrico: validación externa de un modelo predictivo / First trimester screening of late-onset preeclampsia in a low risk and low volume obstetrical setting: external validation of a predictive model

Fundamento: La validación externa de un modelo predictivo de predicción de preeclampsia tardía en un centro de bajo volumen obstétrico en gestantes de bajo riesgo obstétrico. Métodos: Estudio prospectivo de 174 gestaciones únicas de 11+0 a 13+6 semanas de gestación en la Clínica Universidad de Navarra desde septiembre 2011 a marzo de 2013, que fue considerado como una cohorte de validación de un modelo descrito anteriormente para preeclampsia tardía en el hospital Clínic de Barcelona). Resultados: Un total de 7 (4%) mujeres desarrollaron PE tardía. En la cohorte de validación el área bajo la curva del modelo fue de 0,69 (IC del 95% 0,45 a 0,93). Las tasas de detección para un 5, 10 y 15% de tasas de falsos positivos fueron 21,9, 31,4 y 38,6%. Al comparar las áreas bajo la curva de la cohorte de validación con la cohorte de la construcción, no se encontraron diferencias estadísticamente significativas (p = 0,68). Conclusión: La combinación de la historia clínica materna, la proteína placentaria A-asociada al embarazo y presión arterial media es moderadamente útil para predecir preeclampsia tardía en gestantes de bajo riesgo y en un centro de bajo volumen obstétrico. El modelo predictivo del hospital Clinic de Barcelona es una herramienta válida para predecir preeclampsia tardía en este entorno (AU)

Background: The external validation of predictive model of late preeclampsia in a low volume and low risk obstetrical setting. Methods: A cohort was created of 174 singleton pregnancies of 11+0-13+6 gestational weeks at Clinica Universidad Navarra from September 2011 to March 2013, which was considered as a validation cohort of a previously described model for late PE (Hospital Clinic, Barcelona). Results: A total of 7 (4%) women developed late PE. In the validation cohort the area under the curve of the model was 0.69 (95% CI 0.45-0.93). Detection rates for a 5, 10 and 15% of false positive rates were 21.9, 31.4% and 38.6% respectively. When comparing the areas under the curve of the validation cohort with the construction cohort, no statistical differences were found (p=0.68). Conclusion: The combination of maternal history, pregnancy associated plasma protein-A and mean arterial pressure is moderately useful to predict preeclampsia in a low risk and low volume obstetrical setting. The predictive model of the Clinic Hospital of Barcelona is a valid tool in predicting late preeclampsia in this setting (AU)

[First trimester screening of late-onset preeclampsia in a low risk and low volume obstetrical setting: external validation of a predictive model]. / Screening de primer trimestre de preeclampsia tardía en gestantes de bajo riesgo en un centro de bajo volumen obstétrico: validación externa de un modelo predictivo

BACKGROUND: The external validation of predictive model of late preeclampsia in a low volume and low risk obstetrical setting. METHODS: A cohort was created of 174 singleton pregnancies of 11+0-13+6 gestational weeks at Clinica Universidad Navarra from September 2011 to March 2013, which was considered as a validation cohort of a previously described model for late PE (Hospital Clinic, Barcelona). RESULTS: A total of 7 (4%) women developed late PE. In the validation cohort the area under the curve of the model was 0.69 (95% CI 0.45-0.93). Detection rates for a 5, 10 and 15% of false positive rates were 21.9, 31.4% and 38.6% respec-tively. When comparing the areas under the curve of the validation cohort with the construction cohort, no statistical differences were found (p=0.68). CONCLUSION: The combination of maternal history, pregnancy associated plasma protein-A and mean arterial pressure is moderately useful to predict preeclampsia in a low risk and low volume obstetrical setting. The predictive model of the Clinic Hospital of Barcelona is a valid tool in predicting late preeclampsia in this setting.