Antenatal screening for pre-eclampsia: Evaluation of the NICE and pre-eclampsia community guidelines

作者：Verghese L^*; Alam S; Beski S; Thuraisingham R; Barnes I; MacCallum P

来源：Journal of Obstetrics and Gynaecology, 2012, 32(2): 128-131.

DOI：10.3109/01443615.2011.635224

• Antenatal screening
• NICE guidelines
• PRECOG guidelines
• pre-eclampsia
• risk factors

The NICE and PRECOG guidelines are based on systematic reviews of risk factors for pre-eclampsia to identify mothers at risk before 20 weeks%26apos; gestation. Cases (64) and controls (112) were classified retrospectively as screen positive or negative as recommended by the two guidelines The NICE guideline had a higher sensitivity rate of 77% (95% CI 65-87%) vs 59% (95% CI 46-71%) but a lower specificity of 54% (95% CI 44-64%) vs 81% (95% CI 73-88%) with the PRECOG guideline. Based on an incidence of pre-eclampsia of 4% the positive predictive values of PRECOG and NICE guidelines were estimated at only 11% and 7%, respectively. The most discriminatory risk factor was history of pre-eclampsia in a previous pregnancy. Neither guideline has a reasonable performance and cannot be recommended for use in clinical practice. Resources should rather be focussed on development of new strategies to identify women at risk of pre-eclampsia.

• 出版日期2012-2