A Risk Prediction Model Of Gestational Hypertension And Preeclampsia

Background:Hypertensive disorders of pregnancy are one of the leading causes of maternal and neonatal mortality,increasing the long-term incidence of cardiovascular diseases.Preeclampsia and gestational hypertension are the major components of hypertensive disorders of pregnancy.The aim of our study is to establish a prediction model for pregnant women with new-onset hypertension during pregnancy(increased blood pressure after gestational age>20 weeks),thus to guide the clinical prediction and treatment of de novo hypertension.Methods:A total of 117 pregnant women with de novo hypertension who were admitted to Jinan Maternity and Child Care Hospital's obstetrics department were selected as the case group and 199 healthy pregnant women were selected as the control group from January 2017 to June 2018.Independent-sample T test,non-parametric test and chi-square test were performed on the maternal and biochemical indicators of the two groups,and the significant factors were substituted into the logistic regression equation to construct the risk factor prediction model.The receiver operating characteristic curve was used to verify the effectiveness of the model,and a scoring system was established.Results:Eleven indicators have statistically significant difference between two groups(P<0.05).These 11 factors were substituted into the logistic regression equation and 7 independent predictors were obtained which are age,homocysteine,cystatin C,uric acid,total bile acid and albumin respectively.The equation expressed including 7 factors.The calculated area under the curve was 0.884(95%confidence interval:0.848-0.921),the sensitivity and specificity were 88.0%and 75.0%.A scoring system was established to classify pregnant women with scores ?15.5 as low-risk pregnancy group and those with scores>15.5 as high-risk pregnancy group.Conclusions:Our regression equation provides a feasible and reliable means of predicting de novo hypertension after pregnancy.Risk stratification of new-onset hypertension was performed to early treatment interventions in high-risk populations.