Predictability of adverse outcomes in hypertensive disorders of pregnancy: a multicenter prospective cohort study

Objectives To explore variables associated with adverse maternal/fetal/neonatal outcomes among pregnant/postpartum patients admitted to ICU for hypertensive disorders of pregnancy (HDP). Methods Multicenter, prospective, national cohort study. Results Variables independently associated with maternal/fetal/neonatal mortality among 172 patients were as follows: Acute Physiology and Chronic Health Evaluation-II (APACHE-II)(OR1.20[1.06–1.35]), gestational age (OR0.698[0.59–0.82]) and aspartate aminotransferase (AST)(OR1.004[1.001–1.006]). Positive likelihood ratio for headache, epigastric pain, and visual disturbances to predict composite adverse outcomes were 1.23(1.16–1.30), 0.76(0.59–1.02), and 1.1(0.98–1.2), respectively. Conclusions Maternal/fetal mortality due to HDP was independently associated with severity of illness on admission, gestational age, and elevated AST. Accuracy of clinical symptoms to predict composite adverse outcomes was low