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Development and validation of a nomogram for the early prediction of preeclampsia in pregnant Chinese women

Abstract

To make early predictions of preeclampsia before diagnosis, we developed and validated a new nomogram for the early prediction of preeclampsia in pregnant Chinese women. A stepwise regression model was used for feature selection. Multivariable logistic regression analysis was used to develop the prediction model. We incorporated BMI, blood pressure, uterine artery ultrasound parameters, and serological indicator risk factors, and this was presented with a nomogram. The performance of the nomogram was assessed with respect to its calibration, discrimination, and clinical usefulness. Internal validation was assessed. The signature, which consisted of 11 selected features, was associated with preeclampsia status (Pā€‰<ā€‰0.1) for the development dataset. Predictors contained in the individualized prediction nomogram included BMI, blood pressure, uterine artery ultrasound parameters, and serological indicator levels. The model showed good discrimination, with an area under the ROC curve of 0.8563 (95% CI: 0.8364ā€“0.8761) and good calibration. The nomogram still had good discrimination and good calibration when applied to the validation dataset (area under ROC curve of 0.8324, 95% CI: 0.7873ā€“0.8775). Decision curve analysis demonstrated that the nomogram was clinically useful. The nomogram presented in this study incorporates BMI, blood pressure, uterine artery ultrasound parameters, and serological indicators and can be conveniently used to facilitate the individualized prediction of preeclampsia.

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Funding

This work was supported by the program for National Natural Science Foundation of China (No. 81902131) and Shanghai Medical Academy New Star Young Medical talents training subsidy Program (Shanghai Health personnel 2020-087).

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C-YY analyzed the data, drafted the manuscript and contributed to the study design. J-pG contributed to the data analysis. C-yiZ and Y-hN contributed to data collection. C-MY revised the article. All authors reviewed and edited the manuscript and approved the final version of the manuscript.

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Correspondence to Chun-mei Ying.

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The authors declare that they have no conflict of interest.

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The present study conformed to the principles of the Declaration of Helsinki. Approval was obtained from the Research Ethics Committee of the Obstetrics & Gynecology Hospital of Fudan University (approval number: 2019-06).

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Yue, Cy., Gao, Jp., Zhang, Cy. et al. Development and validation of a nomogram for the early prediction of preeclampsia in pregnant Chinese women. Hypertens Res 44, 417ā€“425 (2021). https://doi.org/10.1038/s41440-020-00558-1

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