Predictive Value of Clinical and Laboratory Indices at First Assessment in Women Referred with Suspected Gestational Hypertension

Abstract

Objective: To establish the predictive value of tests in women referred with suspected gestational hypertension (GH) for preeclampsia and other adverse outcomes. Methods: A retrospective analysis of a database of clinical laboratory records of 560 women referred to day care was carried out for the prediction of adverse fetal and maternal outcomes. Results: Gestational age at first presentation < 32 weeks, gestation-standardised blood pressure parameters and serum uric acid were more predictive of the development of preeclampsia, delivery before 34 weeks, severe hypertension and fetal growth restriction than absolute values. Alanine transaminase and platelet counts were not predictive. Conclusion: The predictive value of blood pressure and serum uric acid are improved when they are standardised as z-scores but there appears to be no value to assessing other laboratory indices when women first present with GH without proteinuria.

Keywords:

• Pre-eclampsia
• Day unit
• Hypertension
• Pregnancy
• Blood pressure

ACKNOWLEDGMENTS

We would like to thank all the midwifery and administrative staff of the ODU and Fetal Medicine Unit at the Royal Victoria Infirmary Newcastle who painstakingly maintained the database of ODU visits and pregnancy outcomes.

Declaration of Interests: None of the authors has any conflict of interest relative to this work. DOCA and SCR conceived and designed the study. DOCA and KL collated the data and computed z-scores. DOCA carried out the primary analysis with statistical advice. DOCA and SCR wrote the paper. All authors contributed to writing the manuscript and have approved the final version. Ethical approval was not deemed necessary as the study was a retrospective use of anonymised data. No funding was required.