Oxygen Saturation as a Predictor of Adverse Maternal Outcomes in Women with Preeclampsia

Alexandra L. Millman; Beth Payne; Ziguang Qu; M. Joanne Douglas; Jennifer A. Hutcheon; Tang Lee; Laura A. Magee; Keith R. Walley; Peter von Dadelszen; Barry N. Walters; J. Mark Ansermino; Samantha Benton; Anne Marie Côté; Geoff Cundiff; Andrée Gruslin; Dany Hugo; K. S. Joseph; Sayrin Lalji; Shoo K. Lee; Jing Li; Paula Lott; Jennifer Menzies; Jean Marie Moutquin; Annie B. Ouellet; James A. Russell; Dorothy Shaw; Graeme N. Smith; D. Keith Still; George Tawagi; Brenda Wagner; Swati Mahajan; Amanda Noovao; Phillipa M. Kyle; M. Peter Moore; David Hall; D. Wilhelm Steyn; Christine Biryabarema; Florence Mirembe; Annettee Nakimuli; Fiona Broughton Pipkin; Pamela Loughna; James J. Walker; William Grobman; Eleni Tsigas; Mario Merialdi; Mariana Widmer; for the PIERS (Pre-eclampsia Integrated Estimate of RiSk) Study Group

doi:10.1016/S1701-2163(16)34955-6

Oxygen Saturation as a Predictor of Adverse Maternal Outcomes in Women with Preeclampsia

Alexandra L. Millman, Beth Payne, Ziguang Qu, M. Joanne Douglas, Jennifer A. Hutcheon, Tang Lee, Laura A. Magee, Keith R. Walley, Peter von Dadelszen, Barry N. Walters, J. Mark Ansermino, Samantha Benton, Anne Marie Côté, Geoff Cundiff, Andrée Gruslin, Dany Hugo, K. S. Joseph, Sayrin Lalji, Shoo K. Lee, Jing LiPaula Lott, Jennifer Menzies, Jean Marie Moutquin, Annie B. Ouellet, James A. Russell, Dorothy Shaw, Graeme N. Smith, D. Keith Still, George Tawagi, Brenda Wagner, Swati Mahajan, Amanda Noovao, Phillipa M. Kyle, M. Peter Moore, David Hall, D. Wilhelm Steyn, Christine Biryabarema, Florence Mirembe, Annettee Nakimuli, Fiona Broughton Pipkin, Pamela Loughna, James J. Walker, William Grobman, Eleni Tsigas, Mario Merialdi, Mariana Widmer, for the PIERS (Pre-eclampsia Integrated Estimate of RiSk) Study Group

Obstetrics and Gynecology

Research output: Contribution to journal › Article › peer-review

30 Scopus citations

Abstract

Objective: We sought to determine the role of respiratory assessment by cardiorespiratory symptoms and/or oxygen saturation by pulse oximetry (SpO₂) in predicting adverse maternal outcomes in women admitted to hospital with preeclampsia. Methods: These data derive from an international, prospective multicentre cohort study, PIERS (Pre-eclampsia Integrated Estimate of RiSk), which assesses predictors of adverse outcomes in women admitted to tertiary perinatal units with preeclampsia. Univariate and multivariate analyses of cardiorespiratory symptoms and pulse oximetry were performed to assess their ability to predict a combined adverse maternal outcome developed through international Delphi consensus. Results: SpO₂ successfully predicted adverse maternal outcomes; the area under the receiver-operator characteristic curve (AUC ROC) was 0.71 (95% CI 0.65 to 0.77). Combining the symptoms of chest pain and/or dyspnea with pulse oximetry improved this predictive ability (AUC ROC 0.73; 95% CI 0.67 to 0.78). When SpO₂ was stratified into risk groups using inflection points on the ROC curve, the highest risk group (SpO₂ 90% to 93%) had an odds ratio of 18.1 (95% CI 8.2 to 40.2) for all outcomes within 48 hours when compared with the baseline group (SpO₂ 98% to 100%). Conclusion: Assessing SpO₂ aids in the assessment of maternal risk in women admitted to hospital with preeclampsia. An SpO₂ value of ≤ 93% confers particular risk. The symptom complex of chest pain and/or dyspnea adds to the association.

Original language	English (US)
Pages (from-to)	705-714
Number of pages	10
Journal	Journal of Obstetrics and Gynaecology Canada
Volume	33
Issue number	7
DOIs	https://doi.org/10.1016/S1701-2163(16)34955-6
State	Published - 2011

Keywords

Oximetry
Preeclampsia
Pregnancy

ASJC Scopus subject areas

Obstetrics and Gynecology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/S1701-2163(16)34955-6

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Millman, A. L., Payne, B., Qu, Z., Joanne Douglas, M., Hutcheon, J. A., Lee, T., Magee, L. A., Walley, K. R., von Dadelszen, P., Walters, B. N., Ansermino, J. M., Benton, S., Côté, A. M., Cundiff, G., Gruslin, A., Hugo, D., Joseph, K. S., Lalji, S., Lee, S. K., ... for the PIERS (Pre-eclampsia Integrated Estimate of RiSk) Study Group (2011). Oxygen Saturation as a Predictor of Adverse Maternal Outcomes in Women with Preeclampsia. Journal of Obstetrics and Gynaecology Canada, 33(7), 705-714. https://doi.org/10.1016/S1701-2163(16)34955-6

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title = "Oxygen Saturation as a Predictor of Adverse Maternal Outcomes in Women with Preeclampsia",

abstract = "Objective: We sought to determine the role of respiratory assessment by cardiorespiratory symptoms and/or oxygen saturation by pulse oximetry (SpO2) in predicting adverse maternal outcomes in women admitted to hospital with preeclampsia. Methods: These data derive from an international, prospective multicentre cohort study, PIERS (Pre-eclampsia Integrated Estimate of RiSk), which assesses predictors of adverse outcomes in women admitted to tertiary perinatal units with preeclampsia. Univariate and multivariate analyses of cardiorespiratory symptoms and pulse oximetry were performed to assess their ability to predict a combined adverse maternal outcome developed through international Delphi consensus. Results: SpO2 successfully predicted adverse maternal outcomes; the area under the receiver-operator characteristic curve (AUC ROC) was 0.71 (95% CI 0.65 to 0.77). Combining the symptoms of chest pain and/or dyspnea with pulse oximetry improved this predictive ability (AUC ROC 0.73; 95% CI 0.67 to 0.78). When SpO2 was stratified into risk groups using inflection points on the ROC curve, the highest risk group (SpO2 90% to 93%) had an odds ratio of 18.1 (95% CI 8.2 to 40.2) for all outcomes within 48 hours when compared with the baseline group (SpO2 98% to 100%). Conclusion: Assessing SpO2 aids in the assessment of maternal risk in women admitted to hospital with preeclampsia. An SpO2 value of ≤ 93% confers particular risk. The symptom complex of chest pain and/or dyspnea adds to the association.",

keywords = "Oximetry, Preeclampsia, Pregnancy",

author = "Millman, {Alexandra L.} and Beth Payne and Ziguang Qu and {Joanne Douglas}, M. and Hutcheon, {Jennifer A.} and Tang Lee and Magee, {Laura A.} and Walley, {Keith R.} and {von Dadelszen}, Peter and Walters, {Barry N.} and Ansermino, {J. Mark} and Samantha Benton and C{\^o}t{\'e}, {Anne Marie} and Geoff Cundiff and Andr{\'e}e Gruslin and Dany Hugo and Joseph, {K. S.} and Sayrin Lalji and Lee, {Shoo K.} and Jing Li and Paula Lott and Jennifer Menzies and Moutquin, {Jean Marie} and Ouellet, {Annie B.} and Russell, {James A.} and Dorothy Shaw and Smith, {Graeme N.} and Still, {D. Keith} and George Tawagi and Brenda Wagner and Swati Mahajan and Amanda Noovao and Kyle, {Phillipa M.} and Moore, {M. Peter} and David Hall and Steyn, {D. Wilhelm} and Christine Biryabarema and Florence Mirembe and Annettee Nakimuli and Pipkin, {Fiona Broughton} and Pamela Loughna and Walker, {James J.} and William Grobman and Eleni Tsigas and Mario Merialdi and Mariana Widmer and {for the PIERS (Pre-eclampsia Integrated Estimate of RiSk) Study Group}",

note = "Funding Information: Funding for the PIERS study is provided by Canadian Institutes for Health Research, UNDP/UNFPA/WHO/ World Bank Special Programme of Research, Development & Research Training in Human Reproduction, Michael Smith Foundation for Health Research, and the Child and Family Research Institute. Publisher Copyright: {\textcopyright} 2011 Society of Obstetricians and Gynaecologists of Canada.",

year = "2011",

doi = "10.1016/S1701-2163(16)34955-6",

language = "English (US)",

volume = "33",

pages = "705--714",

journal = "Journal of Obstetrics and Gynaecology Canada",

issn = "1701-2163",

publisher = "Healthcare & Financial Pub.",

number = "7",

}

Millman, AL, Payne, B, Qu, Z, Joanne Douglas, M, Hutcheon, JA, Lee, T, Magee, LA, Walley, KR, von Dadelszen, P, Walters, BN, Ansermino, JM, Benton, S, Côté, AM, Cundiff, G, Gruslin, A, Hugo, D, Joseph, KS, Lalji, S, Lee, SK, Li, J, Lott, P, Menzies, J, Moutquin, JM, Ouellet, AB, Russell, JA, Shaw, D, Smith, GN, Still, DK, Tawagi, G, Wagner, B, Mahajan, S, Noovao, A, Kyle, PM, Moore, MP, Hall, D, Steyn, DW, Biryabarema, C, Mirembe, F, Nakimuli, A, Pipkin, FB, Loughna, P, Walker, JJ, Grobman, W, Tsigas, E, Merialdi, M, Widmer, M & for the PIERS (Pre-eclampsia Integrated Estimate of RiSk) Study Group 2011, 'Oxygen Saturation as a Predictor of Adverse Maternal Outcomes in Women with Preeclampsia', Journal of Obstetrics and Gynaecology Canada, vol. 33, no. 7, pp. 705-714. https://doi.org/10.1016/S1701-2163(16)34955-6

TY - JOUR

T1 - Oxygen Saturation as a Predictor of Adverse Maternal Outcomes in Women with Preeclampsia

AU - Millman, Alexandra L.

AU - Payne, Beth

AU - Qu, Ziguang

AU - Joanne Douglas, M.

AU - Hutcheon, Jennifer A.

AU - Lee, Tang

AU - Magee, Laura A.

AU - Walley, Keith R.

AU - von Dadelszen, Peter

AU - Walters, Barry N.

AU - Ansermino, J. Mark

AU - Benton, Samantha

AU - Côté, Anne Marie

AU - Cundiff, Geoff

AU - Gruslin, Andrée

AU - Hugo, Dany

AU - Joseph, K. S.

AU - Lalji, Sayrin

AU - Lee, Shoo K.

AU - Li, Jing

AU - Lott, Paula

AU - Menzies, Jennifer

AU - Moutquin, Jean Marie

AU - Ouellet, Annie B.

AU - Russell, James A.

AU - Shaw, Dorothy

AU - Smith, Graeme N.

AU - Still, D. Keith

AU - Tawagi, George

AU - Wagner, Brenda

AU - Mahajan, Swati

AU - Noovao, Amanda

AU - Kyle, Phillipa M.

AU - Moore, M. Peter

AU - Hall, David

AU - Steyn, D. Wilhelm

AU - Biryabarema, Christine

AU - Mirembe, Florence

AU - Nakimuli, Annettee

AU - Pipkin, Fiona Broughton

AU - Loughna, Pamela

AU - Walker, James J.

AU - Grobman, William

AU - Tsigas, Eleni

AU - Merialdi, Mario

AU - Widmer, Mariana

AU - for the PIERS (Pre-eclampsia Integrated Estimate of RiSk) Study Group

N1 - Funding Information: Funding for the PIERS study is provided by Canadian Institutes for Health Research, UNDP/UNFPA/WHO/ World Bank Special Programme of Research, Development & Research Training in Human Reproduction, Michael Smith Foundation for Health Research, and the Child and Family Research Institute. Publisher Copyright: © 2011 Society of Obstetricians and Gynaecologists of Canada.

PY - 2011

Y1 - 2011

N2 - Objective: We sought to determine the role of respiratory assessment by cardiorespiratory symptoms and/or oxygen saturation by pulse oximetry (SpO2) in predicting adverse maternal outcomes in women admitted to hospital with preeclampsia. Methods: These data derive from an international, prospective multicentre cohort study, PIERS (Pre-eclampsia Integrated Estimate of RiSk), which assesses predictors of adverse outcomes in women admitted to tertiary perinatal units with preeclampsia. Univariate and multivariate analyses of cardiorespiratory symptoms and pulse oximetry were performed to assess their ability to predict a combined adverse maternal outcome developed through international Delphi consensus. Results: SpO2 successfully predicted adverse maternal outcomes; the area under the receiver-operator characteristic curve (AUC ROC) was 0.71 (95% CI 0.65 to 0.77). Combining the symptoms of chest pain and/or dyspnea with pulse oximetry improved this predictive ability (AUC ROC 0.73; 95% CI 0.67 to 0.78). When SpO2 was stratified into risk groups using inflection points on the ROC curve, the highest risk group (SpO2 90% to 93%) had an odds ratio of 18.1 (95% CI 8.2 to 40.2) for all outcomes within 48 hours when compared with the baseline group (SpO2 98% to 100%). Conclusion: Assessing SpO2 aids in the assessment of maternal risk in women admitted to hospital with preeclampsia. An SpO2 value of ≤ 93% confers particular risk. The symptom complex of chest pain and/or dyspnea adds to the association.

AB - Objective: We sought to determine the role of respiratory assessment by cardiorespiratory symptoms and/or oxygen saturation by pulse oximetry (SpO2) in predicting adverse maternal outcomes in women admitted to hospital with preeclampsia. Methods: These data derive from an international, prospective multicentre cohort study, PIERS (Pre-eclampsia Integrated Estimate of RiSk), which assesses predictors of adverse outcomes in women admitted to tertiary perinatal units with preeclampsia. Univariate and multivariate analyses of cardiorespiratory symptoms and pulse oximetry were performed to assess their ability to predict a combined adverse maternal outcome developed through international Delphi consensus. Results: SpO2 successfully predicted adverse maternal outcomes; the area under the receiver-operator characteristic curve (AUC ROC) was 0.71 (95% CI 0.65 to 0.77). Combining the symptoms of chest pain and/or dyspnea with pulse oximetry improved this predictive ability (AUC ROC 0.73; 95% CI 0.67 to 0.78). When SpO2 was stratified into risk groups using inflection points on the ROC curve, the highest risk group (SpO2 90% to 93%) had an odds ratio of 18.1 (95% CI 8.2 to 40.2) for all outcomes within 48 hours when compared with the baseline group (SpO2 98% to 100%). Conclusion: Assessing SpO2 aids in the assessment of maternal risk in women admitted to hospital with preeclampsia. An SpO2 value of ≤ 93% confers particular risk. The symptom complex of chest pain and/or dyspnea adds to the association.

KW - Oximetry

KW - Preeclampsia

KW - Pregnancy

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U2 - 10.1016/S1701-2163(16)34955-6

DO - 10.1016/S1701-2163(16)34955-6

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AN - SCOPUS:82255166793

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VL - 33

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EP - 714

JO - Journal of Obstetrics and Gynaecology Canada

JF - Journal of Obstetrics and Gynaecology Canada

IS - 7

ER -

Oxygen Saturation as a Predictor of Adverse Maternal Outcomes in Women with Preeclampsia

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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