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

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


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 languageEnglish (US)
Pages (from-to)705-714
Number of pages10
JournalJournal of Obstetrics and Gynaecology Canada
Issue number7
StatePublished - 2011


  • Oximetry
  • Preeclampsia
  • Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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