Assessing the incremental value of blood oxygen saturation (SpO(2)) in the miniPIERS (Pre-eclampsia integrated estimate of risk) risk prediction model

Authors

Beth A. Payne, University of British Columbia
Jennifer A. Hutcheon, University of British Columbia
Dustin Dunsmuir, University of British Columbia
Garth Cloete, Stellenbosch University
Guy Dumont, University of British Columbia
David Hall, Stellenbosch University
Joanne Lim, University of British Columbia
Laura A. Magee, University of British Columbia
Rozina Sikandar Sultanali, Aga Khan UniversityFollow
Rahat Qureshi, Aga Khan UniversityFollow
Erika van Papendorp, Stellenbosch University
J. Mark Ansermino, University of British Columbia
Peter von Dadelszen, University of British Columbia

Document Type

Article

Department

Obstetrics and Gynaecology

Abstract

Objective: To assess the incremental value of blood oxygen saturation (SpO₂) as a predictor in the miniPIERS model, a risk prediction model for adverse outcomes among women with a diagnosis of hypertensive disorder of pregnancy (HDP) in low-resourced settings.

Methods: Using data from a prospective cohort including 852 women admitted to hospital for a HDP, the association between SpO₂ and adverse maternal outcome was assessed using logistic regression. The miniPIERS model was recalibrated and extended to include SpO₂. The incremental value of adding SpO₂ to the model was measured using a net reclassification index (NRI), sensitivity, specificity, positive and negative predictive values, and likelihood ratios.

Results: SpO₂ of < 93% was associated with a 30-fold increase in risk (95% CI 14 to 68) of adverse maternal outcome compared to women with SpO₂ > 97%. After recalibration and extension, the miniPIERS model including SpO₂ (vs. not including SpO₂) had improved sensitivity (32.8% vs. 49.6%) at the cost of minimally decreased specificity (91.5% vs. 96.2%) with a NRI of 0.122.

Conclusion: SpO₂ is a significant independent predictor of risk in women with a HDP. Adding SpO₂ to the miniPIERS model improved the model’s ability to correctly identify high-risk patients who would benefit most from interventions

Publication (Name of Journal)

Journal of Obstetrics and Gynaecology Canada

Recommended Citation

Payne, B. A., Hutcheon, J. A., Dunsmuir, D., Cloete, G., Dumont, G., Hall, D., Lim, J., Magee, L. A., Sultanali, R. S., Qureshi, R., Papendorp, E. v., Ansermino, J. M., Dadelszen, P. v. (2015). Assessing the incremental value of blood oxygen saturation (SpO(2)) in the miniPIERS (Pre-eclampsia integrated estimate of risk) risk prediction model. Journal of Obstetrics and Gynaecology Canada, 37(1), 16-24.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_women_childhealth_obstet_gynaecol/58