Conflict of interest The authors have stated explicitly that there are no conflicts of interest in connection with this article.
How accurate are maternal symptoms in predicting impending complications in women with preeclampsia? A systematic review and meta-analysis
Article first published online: 15 APR 2011
© 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology
Acta Obstetricia et Gynecologica Scandinavica
Volume 90, Issue 6, pages 564–573, June 2011
How to Cite
THANGARATINAM, S., GALLOS, I. D., MEAH, N., USMAN, S., ISMAIL, K. M.K., KHAN, K. S. and FOR TIPPS (TESTS IN PREDICTION OF PRE-ECLAMPSIA'S SEVERITY) REVIEW GROUP (2011), How accurate are maternal symptoms in predicting impending complications in women with preeclampsia? A systematic review and meta-analysis. Acta Obstetricia et Gynecologica Scandinavica, 90: 564–573. doi: 10.1111/j.1600-0412.2011.01111.x
- Issue published online: 18 MAY 2011
- Article first published online: 15 APR 2011
- Accepted manuscript online: 1 MAR 2011 05:02AM EST
- Received: 10 September 2010, Accepted: 23 January 2011
Background. Maternal symptoms such as severe headache, nausea and vomiting, visual disturbances and epigastric pain have been associated with complications in women with preeclampsia. Objective. To determine the accuracy of maternal symptoms in predicting complications in women with preeclampsia by systematic review. Data Sources. We searched MEDLINE (1951–2010), EMBASE (1980–2010), the Cochrane Library (2009) and the MEDION database. Methods of Study Selection. Studies which evaluated the accuracy of symptoms in women with preeclampsia for predicting complications were selected in a two-stage process. Information was extracted by two independent reviewers. We summarized accuracy with a bivariate model estimating sensitivity, specificity and area under the curve. Results. Six primary articles with 2573 women were included. The area under the curve for predicting complications for headache, epigastric pain and visual disturbances was 0.58 (95%CI 0.24–0.86), 0.70 (95%CI 0.30–0.93) and 0.74 (95%CI 0.33–0.94). The sensitivity and specificity of the symptoms in predicting adverse maternal outcomes were respectively as follows: headache 0.54 (95%CI 0.27–0.79) and 0.59 (95%CI 0.38–0.76); epigastric pain 0.34 (95%CI 0.22–0.5) and 0.83 (95%CI 0.76–0.89); visual disturbances 0.27 (95%CI 0.07–0.65) and 0.81 (95%CI 0.71, 0.88); nausea and vomiting 0.24 (95%CI 0.21, 0.27) and 0.87 (95%CI 0.85, 0.89). Conclusion. The presence of symptoms is more useful in predicting complications in preeclampsia compared to their absence in excluding adverse events.