Evidence map›Paper›PMID 40162004›Full record

ArticleAJOG global reports2025

Predicting complications in hypertensive disorders of pregnancy: external validation of a prognostic model for adverse perinatal outcomes.

Klaartje M Olde Loohuis, Kim Luijken, Hannah Brown Amoakoh, Kwame Adu-Bonsaffoh, Diederick E Grobbee, Kerstin Klipstein-Grobusch, Emmanuel Srofenyoh, Mary Amoakoh-Coleman, Joyce L Browne

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Article in AJOG global reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Klaartje M Olde LoohuisDepartment of Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (Olde Loohuis, Brown Amoakoh, Adu-Bonsaffoh, Grobbee, Klipstein-Grobusch, Amoakoh-Coleman, and Browne).
Kim LuijkenDepartment of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (Luijken).
Hannah Brown AmoakohDepartment of Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (Olde Loohuis, Brown Amoakoh, Adu-Bonsaffoh, Grobbee, Klipstein-Grobusch, Amoakoh-Coleman, and Browne).
Kwame Adu-BonsaffohDepartment of Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (Olde Loohuis, Brown Amoakoh, Adu-Bonsaffoh, Grobbee, Klipstein-Grobusch, Amoakoh-Coleman, and Browne).
Diederick E GrobbeeDepartment of Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (Olde Loohuis, Brown Amoakoh, Adu-Bonsaffoh, Grobbee, Klipstein-Grobusch, Amoakoh-Coleman, and Browne).
Kerstin Klipstein-GrobuschDepartment of Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (Olde Loohuis, Brown Amoakoh, Adu-Bonsaffoh, Grobbee, Klipstein-Grobusch, Amoakoh-Coleman, and Browne).
Emmanuel SrofenyohDepartment of Obstetrics and Gynaecology, Greater Accra Regional Hospital, Ghana Health Service, Accra, Ghana (Srofenyoh).
Mary Amoakoh-ColemanDepartment of Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (Olde Loohuis, Brown Amoakoh, Adu-Bonsaffoh, Grobbee, Klipstein-Grobusch, Amoakoh-Coleman, and Browne).
Joyce L BrowneDepartment of Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (Olde Loohuis, Brown Amoakoh, Adu-Bonsaffoh, Grobbee, Klipstein-Grobusch, Amoakoh-Coleman, and Browne).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrediction models can be used as simple evidence-based tools to identify fetuses at risk of perinatal death. Payne et al developed a prognostic model for perinatal death in women with hypertensive disorders of pregnancy, a leading cause of maternal/fetal morbidity and mortality.

objectiveThis study aimed to externally validate the predictive performance of this model in pregnant women with hypertensive disorders of pregnancy admitted between 26 and 34 weeks of gestation in Ghana. STUDY

designThe perinatal model was applied in the SPOT (Severe Pre-eclampsia adverse Outcome Triage) study, a cohort of women with hypertensive disorders of pregnancy admitted between 26 and 34 weeks of gestation to referral facilities in Ghana. Predictive performance was assessed by calibration (calibration-in-the-large coefficient and calibration slope) and discrimination (based on the c-statistic).

resultsOf the 543 women included in the validation analysis, 87 (16%) experienced perinatal death from delivery until hospital discharge. Predictive performance of the model was poor. The calibration-in-the-large coefficient was 1.12 (95% confidence interval, 0.87-1.36, 0 for good calibration), calibration slope was 0.08 (95% confidence interval, -0.21 to 0.36, 1 for good calibration), and c-statistic was 0.52 (95% confidence interval, 0.44-0.59).

conclusionThis perinatal prediction model performed poorly in this cohort in Ghana. Possible reasons include differences in case mix, clinical management strategies, or data collection procedures between development and validation settings; suboptimal modeling strategies at development; or omission of important predictors. Given the burden of perinatal mortality and importance of risk stratification, new prediction model development and validation is recommended.

Indexed as

external validationhypertensive disorders of pregnancyperinatal deathpreeclampsiapregnancyprognosisrisk prediction

Identifiers

PMID40162004
PMCPMC11952792

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.