Prediction of adverse neonatal outcome at admission for early-onset
preeclampsia with severe features: a prospective cohort study.
ABSTRACT Objective: To assess the predictive value for
adverse neonatal outcome of Doppler ultrasound, angiogenic factors and
multi-parametric risk-score models in women with early-onset severe
preeclampsia. Design: Prospective cohort study.
Setting: Maternity units in two Spanish hospitals.
Population: Women with diagnosis of early-onset severe
pre-eclampsia. Methods: A multi-parametric risk score model,
Doppler ultrasound, and levels of angiogenic factors were measured at
admission. The predictive value for adverse neonatal outcome was
calculated. Main outcome measures: Composite of adverse
neonatal outcome. Results: Of 63 women with early-onset severe
preeclampsia, 18 (28.6%) presented an adverse neonatal outcome. PlGF
showed the best discrimination between neonatal outcomes among
angiogenic factors. Good predictive values for the prediction of
neonatal complications were found with the combination of PREP-L score
with advanced Doppler (AUC ROC 0.9 95% CI 0.82-0.98]) and with PlGF
levels (AUC ROC 0.91 [95% CI 0.84-0.98]). Conclusions:
The combination of maternal risk scoring (PREP-L score) with angiogenic
factors or fetal Doppler ultrasound at the time of diagnosis of
early-onset preeclampsia with severe features performs well in
predicting adverse neonatal outcome. Keywords: Angiogenic
factors; Early-onset severe preeclampsia; Hypertension in pregnancy;
Neonatal adverse outcome; Doppler ultrasound; Placental growth factor;
Soluble fms-like tyrosine kinase 1.